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Glycemic Control and Long-term Complications in Pediatric Onset Type 1 Diabetes Mellitus: A Single-center Experience from Northern India

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Abstract

Objective

To study glycemic control, mortality and long-term complications in children with type 1 diabetes (T1D).

Design

Cross-sectional study.

Setting

Referral centre at a government teaching hospital.

Participants

Patients with T1D with age ≤18 years at onset.

Methods

We retrospectively collected demographic data from computer records from 1991 to 2015. Prospective study for outcomes was conducted between 2012 and 2016.

Main outcome measures

Mortality rate, glycosylated hemoglobin (HbA1c), and microvascular complication rate.

Results

The proportion of T1D patients (n=512) <5 years of age at onset was 18.6% between 1995 and 2004, and 24.2% in 2005–2014 (P<0.001). Twenty eight patients had died out of 334 whose living status was known (mortality 1.1 per 100 patientyears over 2549 patient-years follow up). Median (range) HbA1c (n=257) was 8.3% (5.1–15.0%). At least one episode of severe hypoglycemia (coma/seizure/inability to assist self) had occurred in 22.8% patients over two years. Hypertension was present in 11.7% patients. Microvascular complications screen in 164 eligible patients [median (range) age 20 (8–45) y and duration of diabetes 9.1 (5v30) y] showed diabetic nephropathy in 3.0%, proliferative retinopathy in 3.6% and LDL cholesterol >100 mg/dL in 34% patients.

Conclusions

The mortality rate and prevalence of hypertension were high, given the short duration of diabetes of the patients. The proportion of patients with age ≤5 years at onset of diabetes has increased at our center.

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Authors and Affiliations

  1. Departments of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

    Siddhnath Sudhanshu, Veena V Nair, Tushar Godbole, S Vijay Bhaskar Reddy, Eesh Bhatia, Preeti Dabadghao, Pratibha Arora, Sayda Bano, Anulina Singh & Vijayalakshmi Bhatia

  2. Departments of Ophthalmology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

    Kumudini Sharma

Authors
  1. Siddhnath Sudhanshu
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  2. Veena V Nair
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  3. Tushar Godbole
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  4. S Vijay Bhaskar Reddy
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  5. Eesh Bhatia
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  6. Preeti Dabadghao
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  7. Kumudini Sharma
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  8. Pratibha Arora
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  9. Sayda Bano
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  10. Anulina Singh
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  11. Vijayalakshmi Bhatia
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Corresponding author

Correspondence to Vijayalakshmi Bhatia.

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Sudhanshu, S., Nair, V.V., Godbole, T. et al. Glycemic Control and Long-term Complications in Pediatric Onset Type 1 Diabetes Mellitus: A Single-center Experience from Northern India. Indian Pediatr 56, 191–195 (2019). https://doi.org/10.1007/s13312-019-1497-3

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  • DOI: https://doi.org/10.1007/s13312-019-1497-3

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