FACTORS WHICH AFFECT THE

GLYCEMIC CONTROL IN
CHILDREN WITH TYPE 1 DIABETES

Author: Claudiu TEODORESCU

Co-authors: Oana-Mdlina TURTUREA,
Marinela-Georgiana TATU,
Iulia-Anca MARIAN,
Mdlina-Victoria TIA
Coordinators: Assoc. Prof. Ileana PUIU MD, PhD;
G. TARTEA, MD

INTRODUCTION
Type 1 diabetes is among the most common
endocrine and metabolic disorder at children and
adolescents, with a rising incidence worldwide and
in our country.
Diabetes is a chronic disease of children, evolving in
the form of equilibration period, therapeutically
achieved (diet and insulin), alternating with periods
of metabolic imbalance, infection-related, food
excess, lack of suitable therapy.

PATIENTS AND METHODS

The study included 41 patients with type 1 diabetes
diagnosed, registered and monitored in I Pediatric
Clinic, Clinical Emergency County Hospital Craiova.
The study was based on a questionnaire that was
completed by the parents of children and adolescents
with type 1 diabetes after was obtained the parental
accordance with the regulations of the Ethics
Committee of the Emergency County Hospital Craiova.
The aim of the study was to identify factors that
influence glycemic control in children with type 1
diabetes.

PATIENTS
AND METHODS

The questionnaire
completed by parents

RESULTS
The age of patients at the time of the study, was between 4
and 18 years. Children were assigned to three age groups
The incidence by age
groups
7%
0 - 6 yo
34%
7 - 12 yo
59%
13 - 18 yo

The relationship between HbA1c and

age groups
45%

13 - 18 ani

55%

28%

7 - 12 ani

72%

33%

0 - 6 ani
0%

20%

67%
40%

HbA1c<7.51%

60%

80%

100%

HbA1c>7.50%

Analysing the relationship between HbA1c and age groups, was found
that the age group between 7-12 years had most patients (72%) with
glycemic imbalance

RESULTS

The highest incidence of cases depending on the average age of

onset for F sex was 10 years (31.2%); for M sex was 14 years old
(12%), which correlated with puberty.

The incidence based on age of

onset and gender F
35.0%

31.2%

30.0%
25.0%
20.0%
12.5%

15.0%
10.0% 6.2%

6.3%6.3%

6.2%6.2%

12.5%
6.2%

6.2%

5.0%
0.0%

The incidence based on age of

onset and gender M

2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
ani ani ani ani ani ani ani ani ani ani ani ani ani ani ani

14%

12%

12%
10%

8% 8%

8% 8%

8%

8% 8%

8%
6%

4%

4%

4%

4%

4%
2%
0%
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
ani ani ani ani ani ani ani ani ani ani ani ani ani ani ani

RESULTS
The incidence of T1D in area of
origin
46,35%
Rural
Urban

54,65%
Urban

Analysing the relationship

between HbA1c and source
environment, it has been found
that glycemic imbalance
(68.43%) predominated in rural
children.

Rural

Relations between HbA1c and

environment

31.57%

RURAL

68.43%

45.45%

URBAN

0%

20%

54.55%

40%

HbA1c<7.51%

60%

80%

HbA1c>7.50%

100%

RESULTS
Incidence based on the stage of
pubertal
Tanner 5
26.83%
Tanner 1
32.71%

Tanner 2-4
41.46%

Analyzing the relationship

between HbA1c and stage
puberty was found that
children who are Tanner
pubertal stage 5 had most
frequently presented glycemic
imbalance (73%).

The relationship between HbA1c and

pubertal stage
27%

Tanner 5

73%

47%

Tanner 2 - 4

53%

38%

Tanner 1
0%

20%

62%
40%

HbA1c<7.51%

60%
HbA1c>7.50%

80%

100%

RESULTS
Incidence based on the duration
T1DM
0

24.00%
<1 an

32.00%
6 - 12 ani

<1 an

2 - 5 ani
6 - 12 ani

44.00%
2 - 5 ani

Analyzing the relationship between

HbA1c and duration of diabetes have
found that glycemic imbalance occurs
in the first year of evolution (60%), and
between 2-5 of evolution tends to
decrease, followed to grow again
between 6 - 12 years of evolution
(70%).

The relationship between HbA1c and

duration of T1D
30%

6 - 12 ani

70%
44%

2 - 5 ani

56%

40%

<1 an
0%

20%

60%
40%

HbA1C<7.51%

60%
HbA1C>7.50%

80%

100%

RESULTS
Nivelul de educaie al prinilor
29.26% Studii
Universitare

43.90% Studii
Gimnaziale

26.82%
Studii Liceale

In terms of education level

of parents, the highest glycemic
imbalance was met parents who
had only gymnasium studies
(76%), followed by those with
University (66%).

The relationship between HbA1c and

education level of parents
33.34%

Studii Universitare

66.66%
72.72%

Studii Liceale
23.52%

Studii Gimnaziale
0%

20%

27.28%
76.48%

40%

HbA1c<7.51%

60%
HbA1c>7.50%

80%

100%

RESULTS
Membrii familiei cei mai implicai n
ngrijirea Diabetului
24.40% Prini
si copilul

31.70% Mama

43.90% Ambii
Prini

The relationship between

HbA1c and most involved
family members in diabetes
care was found that the
highest glycemic imbalance
occurs when only the parents
are involved(66%), not the
child.

The relationship between HbA1c and

members most involved in the care of
Diabetes
Parinti si copilul

Mama

40%

60%

38.46%

61.54%

33.34%

Ambii Parinti
0%

20%

66.66%
40%

HbA1c<7.51%

60%
HbA1c>7.50%

80%

100%

RESULTS
Setting the diet
36.58%
Experient

63.41%
Cntrire

Analyzing the correlation

between HbA1c and method of
calculation of carbohydrate in
the diet, was found that
glycemic imbalance was more
frequent (80%) in children who
not weighed their food.

The relationship between HbA1c and

how to calculate carbohydrate
20%

Experienta

80%

46.15%

Cantarire
0%

20%

53.85%

40%

HbA1c<7.51%

60%

80%

HbA1c>7.50%

100%

results
Activitatea fizic
34.14%
Sporadic

65.86%
Constant

The relationship between HbA1c and

physical activity showed that children
who were doing physical activity
sporadically, showed glycemic
imbalance in 92%.

The relationship between HbA1c and

physical activity
48.15%

51.85%

Constant

92.86%

Sporadic 7.14%
0%

20%

40%

HbA1c<7.51%

60%

80%

HbA1c>7.51%

100%

RESULTS
Conflicte familiale legate de DZ
9% Nu
22% Mereu

39%
Foarte rar
30% Uneori

Analysing the relationship

between HbA1c and
family conflicts, it was
found that patients who
always family conflicts the
glycemic imbalance is
100%.

The relationship between HbA1c and

family conflicts
100%

Mereu

30%

Uneori

70%
56%

Foarte rar

44%
75%

Nu
0%

20%

40%
HbA1c<7.51%

25%
60%
HbA1c>7.50%

80%

100%

CONCLUSIONS

Analyzing the factors that influence glycemic control at children

with type 1 diabetes, we found:

The age group between 7 - 12 years most patients (72%) had a

glycemic imbalance;

For children from rural areas there was a higher prevalence of

glycemic imbalance (68.43%) compared to urban areas;

Children who have family conflicts always have glycemic

imbalance(100%);

Children who were doing physical activity sporadically, showed

glycemic imbalance in 92%.

The children who not weighed the food to establish the

carbohydrate in the diet, showed glycemic imbalance in 80%;
The children whose parents had only gymnasium studies had the
highest glycemic imbalance (76% of cases);
The children in Tanner pubertal stage 5 had glycemic imbalance
most frequently (73% of cases);
Glycemic imbalance occurs more frequently in the first year of
development (60% of cases);
Glycemic imbalance occurs more frequently (66%), when are
involved in only parents and not the children, in the diet.

Thank you!