Microvascular complications in children and adolescents with type 1 diabetes mellitus in Assiut governorate, Egypt

IF 0.5 Q4 PEDIATRICS Egyptian Pediatric Association Gazette Pub Date : 2018-12-01 DOI:10.1016/j.epag.2018.10.003

Eman B. Kamaleldeen , Hanaa A. Mohammad , Ebtsam F. Mohamed , Ahmed G. Askar

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引用次数: 7

Abstract

Background

Type 1 diabetes mellitus (T1DM) carries a long-term burden of increased microvascular complications in the form of nephropathy, retinopathy, and neuropathy. As the incidence of T1DM continues to rise, the burden of microvascular complications will also increase and negatively influence the prognosis of young patients. Microalbuminuria (MA) represents the earliest clinical indication of diabetic nephropathy and is a predictor of increased cardiovascular morbidity and mortality. Our study’s aim was to determine the prevalence of microvascular complications among type 1 diabetic patients in Assiut University Children Hospital, Upper Egypt and to find out its correlation with various risk factors.

Methods

The study was cross-sectional one carried on a sample of 180 type 1 diabetic children and adolescents aged from 6 to 21  years. Patients were subjected to full history taking, physical examination, and investigations of HbA1c, lipid profile, early morning spot urine albumin/creatinine ratio as well as fundus examination.

Results

The prevalence of microalbuminuria was 20.5%, macroalbuminuria was 7.8%, diabetic retinopathy was 1.1%, and diabetic neuropathy was 5.5%. Patients with microvascular complications had a significantly higher frequency of DKA (39.2% vs. 10.6%, p = 0.000) and hypoglycemic attacks (47.1% vs. 29.5%, p = 0.001) than those without microvascular complications. Furthermore, studied patients with microvascular complications had significantly higher mean ± SD HbA1c (9.99 ± 1.61 vs. 8.51 ± 1.5, p = 0.000) and serum cholesterol (174.98 ± 48.12 vs. 166.26 ± 43.28, p = 0.05) in comparison to patients without microvascular complications.

Conclusion

The prevalence rate of microvascular complications was considerably high among diabetic patients in Assiut governorate, Egypt especially with poor glycemic control and dyslipidemia. Regular screening for microvascular complications is recommended for all diabetic patients, as early treatment is critical for reducing cardiovascular risks and slowing the progression to late stages of diabetic nephropathy.

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埃及Assiut省1型糖尿病儿童和青少年的微血管并发症

背景:1型糖尿病(T1DM)具有长期增加的微血管并发症，包括肾病、视网膜病变和神经病变。随着T1DM发病率的不断上升，微血管并发症的负担也会增加，并对年轻患者的预后产生负面影响。微量白蛋白尿(MA)是糖尿病肾病的最早临床指征，是心血管发病率和死亡率增加的预测指标。我们的研究目的是了解上埃及Assiut大学儿童医院1型糖尿病患者微血管并发症的发生率及其与各种危险因素的相关性。方法采用横断面法对180例6 ~ 21岁  岁的1型糖尿病儿童和青少年进行研究。患者全部接受病史记录、体格检查、HbA1c、血脂、晨斑尿白蛋白/肌酐比值及眼底检查。结果微量白蛋白尿患病率为20.5%，大量白蛋白尿患病率为7.8%，糖尿病视网膜病变患病率为1.1%，糖尿病神经病变患病率为5.5%。有微血管并发症的患者DKA发生率(39.2%比10.6%，p = 0.000)和低血糖发作发生率(47.1%比29.5%，p = 0.001)明显高于无微血管并发症的患者。此外,研究患者微血管并发症有显著较高的意思是 ± SD糖化血红蛋白( 9.99±1.61 vs 8.51  ± 1.5,p = 0.000)和血清胆固醇( 174.98±48.12 vs 166.26  ± 43.28,p = 0.05)相比,患者没有微血管并发症。结论埃及Assiut省糖尿病患者微血管并发症发生率较高，尤其是血糖控制较差和血脂异常患者。建议所有糖尿病患者定期筛查微血管并发症，因为早期治疗对于降低心血管风险和减缓糖尿病肾病进展到晚期至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Egyptian Pediatric Association Gazette PEDIATRICS-

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审稿时长

9 weeks

期刊介绍： The Gazette is the official journal of the Egyptian Pediatric Association. The main purpose of the Gazette is to provide a place for the publication of high-quality papers documenting recent advances and new developments in both pediatrics and pediatric surgery in clinical and experimental settings. An equally important purpose of the Gazette is to publish local and regional issues related to children and child care. The Gazette welcomes original papers, review articles, case reports and short communications as well as short technical reports. Papers submitted to the Gazette are peer-reviewed by a large review board. The Gazette also offers CME quizzes, credits for which can be claimed from either the EPA website or the EPA headquarters. Fields of interest: all aspects of pediatrics, pediatric surgery, child health and child care. The Gazette complies with the Uniform Requirements for Manuscripts submitted to biomedical journals as recommended by the International Committee of Medical Journal Editors (ICMJE).