Chronic Microvascular Complication of Type 1 Diabetes Mellitus and Its Predictors Among Children with Type 1 Diabetes Mellitus in Ethiopia; A Single Center Experience: Ambi Directional Cohort Study

Abstract

Introduction

Type 1 diabetes mellitus is the most common pediatric endocrine disorder. Poor glycemic control in diabetes mellitus can result in microvascular complications (retinopathy, neuropathy, and nephropathy). There is no study done in our setting either about prevalence of pediatric type 1 diabetes mellitus or chronic microvascular complication among these patients, which gap this study is expected to fill.

Objective

This study aimed to assess the risk and predictors of chronic microvascular complication of type 1 diabetes mellitus among children with diabetes at Haramaya University Hiwot Fana Compressive Specialized Hospital from September 10, 2021 to January 30, 2023.

Methods

A hospital-based Ambi directional cohort study was conducted. Survival data are described by follow-up time and Kaplan–Meier graph. To determine predictors associated with chronic microvascular complication we used a Poisson regression optimal model selected using the information criterion. All associations are tested at the 95% confidence level and a reported IRR P-value less than 0.05 is declared as a significant association between variables.

Results

A total of 124 children with type 1 diabetes mellitus were followed with total 407.5 years risk time. The overall incidence rate of chronic microvascular complication was 83 per 1000 population per year (95% CI: 59−116). The median time for detection of microvascular complication was 7 years after diagnosis. Being male with IRR 1.71 (95% CI: 0. 0.81–3.56), being at pubertal age IRR 1.91 (95% CI: 1.05–3.48), longer diabetes mellitus duration IRR 1.13 (95% CI: 1.07–1.28), and poor glycemic control IRR 1.50 (95% CI: 0.46–4.97) were found to be at higher risk for chronic microvascular complication.

Conclusion

There was high incidence of chronic microvascular complication of diabetes mellitus. Being pubertal age group and more than 3 years duration after diagnosis had statistically significant association with complication.

Keywords:

• pediatric diabetes mellitus
• microvascular complication
• Harar

Acknowledgments

We would like to express our gratitude to all health care professional staff working at the pediatric diabetes mellitus follow-up clinic during the observation period and our coworkers who give us continuous support and constructive ideas from beginning to end of this thesis. We also forward our gratitude to Haramaya University for the opportunity, support, and availing the final thesis on the university website for accessibility. This paper is based on the epidemiology thesis of Konjit Eshetu, Lemma Demissie, and Merga Dehresa. It has been published on the institutional website: http://ir.haramaya.edu.et//hru/handle/123456789/7219

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest.