Title: Determinants of loss of glycemic control in patients with type 1 diabetes mellitus. Prospective cohort study from Iraq
Abstract: Background: Despite advances in insulin therapeutics during the past 25 years, only a few individuals with type 1 diabetes achieve glycemic control.The aim of this study is to assess the determinants of loss of glycemic control in patients with type 1 diabetes mellitus in Basrah, Iraq.Methods: The data presented are derived from the Al-Faiha Diabetes Endocrine and Metabolism Center (FDEMC) in Basrah.Eligible patients were those with type 1 diabetes.Follow-up started from August 2008 to the end of February 2012.Seven hundred and forty one patients completed the study.Results: Deterioration of glycemic control was seen in 42.8%.Those who achieved age group specific target HbA1c were 12.4%.Those with worse glycemic control are younger age (21.0±10.4 vs. 23.1±10.9;p=0.01), have lower education level (9.45±2.0 vs. 11.75±2.6;P=0.01) and lower baseline HbA1C percent (9.45±2.048 vs. 11.75±2.619;p <0.0001) than those with more optimal glycemic control.Conclusion: Factors contributing to worse glycemic control were lower age, less education level, and lower baseline HbA1c.Factors that do not contribute to loss of glycemic control are: gender, number of visits, urban/rural, family history, duration of diabetes, self-monitoring of blood glucose (SMBG) use, Body mass index (BMI) or use of pen for insulin delivery.