Microvascular complications in children and adolescents with type 1 diabetes mellitus in Assiut governorate, Egypt

Abstract

Background: Type 1 diabetes mellitus (T1DM) carries a long-term burden of increased microvascular complications in the form of nephropathy, retinopathy, and neuropathy. As the incidence of T1DM continues to rise, the burden of microvascular complications will also increase and negatively influence the prognosis of young patients. Microalbuminuria (MA) represents the earliest clinical indication of diabetic nephropathy and is a predictor of increased cardiovascular morbidity and mortality. Our study’s aim was to determine the prevalence of microvascular complications among type 1 diabetic patients in Assiut University Children Hospital, Upper Egypt and to find out its correlation with various risk factors. Methods: The study was cross-sectional one carried on a sample of 180 type 1 diabetic children and adolescents aged from 6 to 21 years. Patients were subjected to full history taking, physical examination, and investigations of HbA1c, lipid profile, early morning spot urine albumin/creatinine ratio as well as fundus examination. Results: The prevalence of microalbuminuria was 20.5%, macroalbuminuria was 7.8%, diabetic retinopathy was 1.1%, and diabetic neuropathy was 5.5%. Patients with microvascular complications had a significantly higher frequency of DKA (39.2% vs. 10.6%, p = 0.000) and hypoglycemic attacks (47.1% vs. 29.5%, p = 0.001) than those without microvascular complications. Furthermore, studied patients with microvascular complications had significantly higher mean ± SD HbA1c (9.99 ± 1.61 vs. 8.51 ± 1.5, p = 0.000) and serum cholesterol (174.98 ± 48.12 vs. 166.26 ± 43.28, p = 0.05) in comparison to patients without microvascular complications. Conclusion: The prevalence rate of microvascular complications was considerably high among diabetic patients in Assiut governorate, Egypt especially with poor glycemic control and dyslipidemia. Regular screening for microvascular complications is recommended for all diabetic patients, as early treatment is critical for reducing cardiovascular risks and slowing the progression to late stages of diabetic nephropathy. Keywords: Microvascular complications, Screening, Type 1 diabetes mellitus