Background: Iron deficiency anemia (IDA) in children with type I diabetes (T1D) represents a significant burden. Aim of Study:To asses iron status in children and adolescent with T1D of and to correlate it with glycemic control and diabetic vascular complications.Patients and Methods: Two hundred children with T1D recruited from Pediatrics and Adolescent Diabetes Unit (PADU), Ain Shams University in the period from December 2019 to July 2020. They were 123 males (61.5%) and 77 females (38.5%) aged 10.97 ±3.93 years (Range: 2-18 years). History taking, fundus examination and general examination were done stressing on anthropometric measurements. Laboratory evaluation including complete blood count, glycosylated haemoglobin (HbA1c), urinary albumin/creatinine ratio (ACR), lipid profile and patients with microcytic hypochromic anaemia underwent Serum iron, total iron-binding capacity (TIBC), serum ferritin, Hepcidin, Anti-tissue transglutaminase (IgA), Occult blood in stool and H-pylori antigen in stool.Results: Seventy two of diabetic children were anemic (36%) and fifty one had IDA (25.5). IDA was more prevalent in males. Children with T1D and IDA experienced more clinically significant hypoglycemic attacks, more DKA attacks, high fatigue severity scale and history of menorrhagia. Low body weight, low BMI, low mean corpuscular volume (MCV), high TIBC and low hepcidin level were present in diabetic children with IDA. They also had high HbA1c, neuropathy, high triglycerides and high level of low density lipoprotein (LDL cholesterol).Conclusions: IDA is a significant morbidity among children with T1D and it should be screened. Serum hepcidin levels are significantly associated with iron status in children, and could be useful indicators of ID.
The present study evaluates the anti-diabetics and glycemic control of type 2 diabetic patients attending the out-patients clinics Aden. It is a cross-sectional study carried out in Aden Diabetic Center at Al-Gamhouria General Modern Hospital, Aden. Thirty two type-2-patients attended the center during the period from 15 January to 15 February 2018, using anti-diabetic drugs for more than one year, were included. Data were collected through direct interviews using a structured questionnaire, including patients characteristics as well as medical and medications characteristics. Blood samples were drawn to measure glycated hemoglobin HbA1c. Data were analyzed by using SPSS. (Version 22). Thirty seven and a half percent were females and 62.5% males. The mean age of the participants was 55 ±8.23 years. 56.2% of the patients showed good adherence to the exercise with the preponderance to the males, p=0.043. The mean BMI of the participants was 26.62± 3.89 Kg/m2, with half of them considered overweight (25-29.9 Kg/m2), while almost one fifth of the samples were obese. Half of the patients had hypertension and high cholesterol as comorbid conditions. The most frequent antidiabetic classes utilized by the patients were sulfonylureas, 62.5% and biguanides 62.5%. There was a limited use of DPP-4 inhibitors, sitagliptin and alogliptin (6.2%). 53.1% of the studied patients utilized monotherapy, followed by a combination of oral antidiabetics 37.55%, and a combination of oral antidiabetics and insulin (9.3%). The mean value of HbA1c of the samples studied was 9.65 ±2.33%. Only 12.5% of the patients had good glycemic control and 87.5% of the participants had HbA1c of ≥ 7 %. Almost forty percent of the patients with HbA1c ≥7% had cardiovascular diseases such as hypertension and higher cholesterol (p=0.019). In conclusion, the most frequent antidiabetic classes utilized by type-2-patients who attended outpatients clinics were sulfonylureas and biguanides with a tendency to use combination regimens. The majority of patients had poor glycemic control associated with cardiovascular morbidity. Attention should be given on the treatment regimens and dosage.
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