Forthcoming Issue Vol. 20 No. 1 Growth assessment of children and adolescents with type 1 diabetes mellitus at Steve Biko Academic Hospital in Pretoria, South Africa: A cross-sectional study of factors contributing to stunting
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Abstract
Background:
The continuous rise in the prevalence of Type 1 diabetes mellitus (T1DM) places pressure on countries to increase the needed resources to manage patients adequately. Studies have documented an association between poor glycemic control and stunting, which poses a significant health concern. In South Africa, there is minimal data on the prevalence of stunting in T1DM.
Objective:
To establish the prevalence of stunting in a population of T1DM patients and determine contributing factors.
Methodology:
A descriptive cross-sectional study was conducted on patients with T1DM attending the Paediatric Diabetic Clinic of Steve Biko Academic Hospital. Data was collected from patient files, a questionnaire and the National Health Laboratory Service database.
Results:
Of the 169 recruited patients, 115 were included, with 56.5% female. In this cohort, the prevalence of stunting was 25.2% using mid-parental height (MPH), while it was underestimated using only standardised CDC (12.2%) and WHO (13%) growth charts. The median haemoglobin A1C (HbA1C) was 11.8%. Poor glycemic control and male sex had a statistically significant association with stunting in T1DM, with p-values of 0.033 and 0.006, respectively.
Conclusion:
This study found that the only significant associations between stunting in T1DM were poor glycemic control and male sex. This study indicates the importance of insulin as a growth-modifying factor and therefore the importance of treatment compliance. Providing education to this population through a multidisciplinary team is needed. It is further recommended that screening for stunting using MPH, alongside standardised growth charts, should be incorporated into all levels of care.
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