Chronic Complications of Type 1 Diabetes in Children

Chronic complications of type 1 diabetes are rare in childrenThe aim of this work is to determine their prevalence in paediatric settings and the factors associated with themMethodology: This was a prospective study, conducted in two reference services in the management of childhooddiabetes at the University Hospital of Dakar. We included all patients with type 1 diabetes under 20 years of age asrecommended by the 2009 ISPAD.Results: Of the 67 patients in our cohort, only 46 met the inclusion criteria. There were 19 boys and 27 girls. Theaverage age was 11.57 years +/- 4.3 years. The average age of discovery was 8.71+/- 3.8 years. The average durationof the evolution was 34 months. Almost half of the patients had an average glycated hemoglobin greater than 9%.Growth retardation was severe in 17% and moderate in 11% of cases. Five patients (20%) had significantmicroalbuminuria and 5 (20%) had retinopathy, 3 with macular edema and 2 with diffuse microhaemorrhages.Multivariate analysis of the different parameters studied showed that retinopathy was associated with high HbA1cvalues (p=0.043) and poor compliance (p=0.021). Kidney disease was only associated with poor adherence with p=0.0025.Conclusion: Chronic complications of T1D are not that uncommon, especially in our regions where management is notoptimal. We suggest that they be detected around 10-11 years of age regardless of how long the diabetes progresses.