Endocrine Abstracts

Background: Type1 diabetes is the third most common chronic illness in childhood following asthma and cerebral palsy. Adolescence is characterized by physical and psychological changes and there is global evidence suggesting that metabolic control deteriorates during the period of teenage.

Aims: To study the characteristics of a group of Tunisian adolescents with type 1 diabetes and describe the various metabolic complications observed.

Methods: Cross sectional study concerning 102 adolescents with type 1 diabetes hospitalized or followed at the consultation of diabetology of the Institute of Nutrition in Tunis over a one-year period between January 2017 and January 2018.

Results: The study population consisted of 102 adolescents with type 1 diabetes. 51% were female (sex ratio = 0.96). Participants classified underweight (UW) were 3(2.9%), those of normal weight (NW) were 82 (80.4%), overweight (OW) 10 (9.8%) and obese (O)7 (6.9%). Abdominal obesity was present in 21.6% of our patients with a significant female predominance (girls:34.6%, boys:8%, P < 10^–3).

The mean duration of diabetes was 7.1 ± 4.3 years. The majority (78.9%) of our patients had an HbA1c level > 9%. Therapeutic adherence was low in 29.4%. Insulin omission was present in 7.8% of patients (girls: 11.5% vs boys: 4%; P = 0.2). Diabetic retinopathy, nephropathy, and neuropathy were found respectively in 3.9%, 5.9%, and 5.9%. Moderate and severe hypoglycemia rate in the past 3 months were respectively 11.8 ± 16.2 and 1.8 ± 7.9 per month. The average number of ketosis or Ketoacidosis decompensations in the last year was 3.6 ± 6.3 per year. The average number of hospitalizations per year was 2.2 ± 1.9. The average length of hospital stay was 9.2 ± 5.1 days. Dyslipidemia was diagnosed in 30.4% of diabetics with a significantly higher frequency in girls (girls: 38.5% vs boys: 22%; P = 0.05). The school failure rate was high (50%) in our series.

Conclusions: Metabolic control of type 1 diabetes is difficult during adolescence due to hormonal fluctuations. Ketoacidosis decompensations and severe hypoglycemia are the most common complications in adolescents with type1 diabetes and may affect the academic performance of these young people by increasing the frequency of hospitalizations. Additional efforts are needed to improve the quality of care for young diabetics.