Glycemic control and complications of type 1 diabetes among children in Tanzania

S Najem; E S Majaliwa; K Ramaiya; A B M Swai; D Jasem; J Ludvigsson

doi:10.1016/j.jcte.2020.100245

Glycemic control and complications of type 1 diabetes among children in Tanzania

J Clin Transl Endocrinol. 2020 Dec 11:23:100245. doi: 10.1016/j.jcte.2020.100245. eCollection 2021 Mar.

Authors

S Najem¹, E S Majaliwa², K Ramaiya³, A B M Swai⁴, D Jasem¹, J Ludvigsson⁵

Affiliations

¹ Div. of Pediatrics, Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
² Department of Pediatric and Child Health, Muhimbili National Hospital, Dar es Salaam, Tanzania.
³ Department of Internal Medicine, Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania.
⁴ Tanzania Diabetes Association, Dar es Salaam, Tanzania.
⁵ Crown Princess Victoria Children's Hospital and Div. of Pediatrics, Dept. of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Abstract

Introduction: Knowledge on Type 1 Diabetes (T1D) in sub-Saharan Africa is scarce. This study aimed at assessing microvascular complications of Type 1 diabetes in young patients.

Method: A retrospective study based on medical recordings from 2010-2016 was done. 604 children and young adults with T1D were recruited from five hospitals with pediatric diabetes clinics. 559 patients aged 2-35 years with known date of birth were included. Clinical data on retinopathy and neuropathy were analyzed. There was no information on renal function/ nephropathy.

Results: Most data were missing. There was documentation on HbA1C, plasma glucose and complications in less than half of the patient files. Of those with registered HbA1c values (42.2%), 36% had HbA1c > 12.5%. There was high prevalence of retinopathy (21.5%) and neuropathy (29.4%) in spite of short mean duration of diabetes (6.2 ± 4.1 years).

Conclusion: Many patients with T1D in Tanzania have poor metabolic control. Microvascular complications are common already after a short duration of diabetes, but the results have to be interpreted with great caution because of study limitations. Better pediatric diabetes care as well as increased awareness of diabetes is needed. Studies in resource-poor countries need careful planning, if possible with prospective design.

Keywords: Complications; HbA1c; Neuropathy; Retinopathy; Tanzania; Type 1 diabetes.