Endocrine Abstracts

Recent years have been marked by numerous advances in the quality of type 1 diabetes care. However, glycemic control remains suboptimal for many patients even in developed countries.

The aim of this study was to assess glycemic control in a cohort of Tunisian type 1 diabetic patients and to identify factors associated with poor glycemic control.

Methods: One hundred and eighty-eight type 1 diabetic patients admitted to the Endocrinology - Diabetology department of the university hospital “La Rabta” then followed up in the consultation for at least one year, were studied in a retrospective manner during five years.

Results: Mean age of patients was 28±12.3 years (102 males and 86 females). One hundred and thirty two patients (70.2%) had newly diagnosed diabetes and 56 (29.8%) had previously diagnosed diabetes with a mean duration of 7±6.3 years. Mean HbA1c during the follow-up period was 9.7±3%. It was less than 7% in 16.8% of cases. There was a reverse correlation between age at diabetes onset and HbA1c value (P=0.02). Adolescents had higher HbA1c value than adults (10.8±2.9% vs 9.2±2.8%, P=0.02). No relationship was found between number of daily insulin injections and mean HbA1c value. Mean HbA1c was higher in patients who did not adhere to their insulin treatment (11.1±3.3% vs 8.9±2.4%, P<0.0001), in those with less than 3 clinic visits per year (10.7±3.5% vs 9.0±2.2%, P=0.001), in patients with lipohypertrophy (10.9±2.5% vs 9.2±3.4%, P=0.008) and those with known celiac disease (14.5±5.2% vs 9.6±2.9%, P=0.005).

Conclusion: The overall glycemic control of our type 1 diabetic patients is poor. Several factors are associated with this. We have to target these factors, in particular by intensifying education strategies, to improve the prognosis of these patients.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.