Type 1 diabetes (T1D) in children is linked to a high risk of developing microvascular and macrovascular complications. HbA1c is an indicator for assessing long-term glycemic outcomes and a modifiable risk factor directly related to diabetes complications. The study aim was to describe glycemic outcomes of children with T1D at baseline and over a 2-year follow-up period post diagnosis as well as identify factors associated with optimal glycemic control. This retrospective cross-sectional study included patients (aged ≤14) with T1D registered in the Childhood Onset Diabetes electronic Registry (CODeR) between 2011-2017. Baseline data was retrieved through CODeR and follow-up data was retrieved by medical chart review. Optimal glycemic control was defined as HbA1c <7.5% per the International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines at the follow-up period. ANOVA, chi-square, and logistics regression analysis was used. A total of 799 patients (53% females) were included at baseline. Mean (SD) age at diagnosis was 7.70 (3.10) and mean (SD) HbA1c was 11.3% (2.3) . HbA1c was significantly different between females and males at baseline (11.6% vs. 10.9%; p<0.001) . In the follow-up period, 580 patients were included. Most patients achieved sub-optimal or high-risk compared to optimal glycemic control at follow-up (n=503, mean HbA1c 9.8% vs. n=77, mean HbA1c 6.9%; p<0.001) . Patients on CSII therapy were more likely to have better glycemic outcomes than patients on MDI therapy (OR = 4.86, 95% CI [1.66-14.2], p=0.004) . Height z-score was associated with poor glycemic control (OR = 1.24, 95% CI [1.017-1.515], p=0.034) . Most patients did not meet the glycemic control target defined by ISPAD, signaling a significant challenge faced by children with T1D in Kuwait. However, this study highlights the importance of making CSII therapy accessible. Individualized glycemic control goals may be needed to enhance diabetes management and care early at diagnosis.
T.Alqaisi: None. A.R.Alsaber: None. H.Alkandari: None. D.Al-abdulrazzaq: None.