Survey on Acute and Chronic Complications in Children and Adolescents with Type 1 Diabetes at Muhimbili National Hospital in Dar es Salaam, Tanzania

Abstract

OBJECTIVE- To assess glycaemic control and complications of type 1 diabetes in children and adolescents in Tanzania.

RESEARCH DESIGN AND METHODS- This demographic and clinical survey, included 99 children attending Muhimbili National Hospital Clinic for Diabetes, aged between 5 and 18 years. A structured questionnaire was used for evaluating socio-economic data and for estimation of the prevalence of acute complications occurring over the last 6 months. Prevalence of retinopathy was determined by fundus ophthalmoscopy and diabetic nephropathy by microalbuminuria.

RESULTS- All these children were treated with conventional insulin regimen mean duration of diabetes was 4.76±3.58 years.

RESULTS- Only one child (1%) had good glycaemic control (HbA1c <7.5%), 60 children (60.6%) had moderate glycaemic control (HbA1c7.5-10%), 14 (14.1%) had poor glycaemic control (HbA1c >10-12.5%) and 24 (24.2%) had very poor glycaemic control (HbA1c >12.5%). At onset of diabetes 75% of children presented with diabetic ketoacidosis (DKA). Eighty-nine children (89.80%) had at least one episode of DKA and 55 children (55.67%) presented symptomatic hypoglycemic episodes. Microalbuminuria was present in 29 (29.3%) and retinopathy in 22 (22.68%) patients.

CONCLUSIONS- Although there are some methodological limitations, this survey highlights the difficulties of getting good metabolic control and the high prevalence of acute and chronic complications in Tanzanian children with type 1 diabetes. These results clearly show that major efforts are needed to improve quality of care in children with type 1 diabetes in Tanzania.