Background: Type 1 Diabetes Mellitus is a rapidly growing problem in Tanzania. Children and adolescents with\ntype 1 diabetes have previously been found to have poor glycaemic control and high prevalence of complications.\nStrict glycaemic control reduces the incidence and progression of chronic complications. The aim of this study was\nto identify the factors associated with glycaemic control among children and adolescents.\nMethods: A cross sectional study was done at the diabetes clinic for children and adolescents. Data on\nsocioeconomic, demographic and diabetes specific variables including adherence, diabetes knowledge, caregivers\nknowledge and their involvement in the care of the child was obtained. Glycaemic control was assessed by\nmeasuring glycosylated hemoglobin. (HbA1C). Linear regression analysis was done to determine factors associated\nwith glycaemic control\nResults: Seventy-five participants were recruited into the study (51 % males). The mean HbA1c was 11.1 Ã?± 2.1 %.\nChildren aged <10 years were found to have a significantly better glycaemic control (9.8 %) as compared to 10ââ?¬â??\n14 year olds (11.5 %) and >14 year olds (11.4 %) (P value = 0.022). Sixty-eight percent of patients had good\nadherence to insulin while adherence to blood glucose monitoring regimen was 48 % and to diet control was\n28 %.\nYounger age, having the mother as the primary caregiver, better caregiver knowledge of diabetes, better\nadherence to blood glucose monitoring regimen and diabetes duration of less than 1 year were associated with\nbetter glycaemic control.\nIn multivariate analysis, age, adherence to blood glucose monitoring regimen and the mother as the primary\ncaregiver were found to independently predict glycaemic control (R2 = 0.332, p value = 0.00).\nConclusions: Children and adolescents with type 1 diabetes in Dar es Salaam have poor glycaemic control. In\norder to improve metabolic control, adherence to blood glucose monitoring should be encouraged and caregivers\nencouraged to participate in care of their children especially the adolescents.
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