Factors Affecting Glycemic Control in Pediatric Type 1 Diabetes Mellitus: A Multivariate Regression Analysis

Abstract

Several factors have been reported to affect glycemic control, the significance of most of which is still a topic of discussion. Therefore, we aimed to investigate such effects in more detail. We conducted our cross-sectional analysis on 163 children and adolescents 2 to 18 with T1DM. Moreover, we obtained their demographic and clinical information in addition to glycated hemoglobin (HbA1C) levels and performed a multivariate regression analysis to determine their effects. Among the investigated factors parents living together (P<0.001), higher parental education (P<0.001), level of monthly income (P<0.001), and residing in urban areas (P<0.001), positive history of hospitalization due to ketoacidosis (P=0.001), injection site lipodystrophy (P=0.005), physical activity (P<0.001), regular endocrinology clinic visits (P<0.01), physician long distance access (P<0.001), social media usage (P<0.001), nutritionist supervision (P<0.001), regular visits by a mental health expert (P=0.02), body mass index (P=0.449, P<0.001), daily insulin units (r=0.447, P<0.001), height Z score (r= -0.177, P=0.024), and duration of Diabetes (r= -0.199, P=0.011) significantly affected HbA1C levels. Furthermore, the regression model significantly predicted 56.4% of the changes in HbA1C. With environmental and family-related factors proving pivotal, educational interventions and implementing relevant policies are crucial. Financial aid to those affected by facilitating access to healthcare- related technologies and state-of-the-art care centers can also pay substantial dividends.