Vol. 6, Issue 1, Part A (2024)

Background: The primary objective of diabetes management is to achieve and sustain optimal glycemic control from the first phase of diabetes, with the aim of averting the initiation and advancement of diabetic micro vascular problems.
Aims of the study: Investigate biochemical changes associated with glycemic variability and their effect on kidney function.
Methodology: A cross-sectional study including 100 patients (52 males and 48 females) diagnosed with type 1 diabetes at Al-Fayhaa Specialized Diabetes Center in Basra, Iraq. Participants range in age from 6-17 years. Blood and urine samples were collected between November 2023 and March 2024 after obtaining verbal consent. The study excluded patients with kidney and liver diseases or immune diseases. 5 ml of blood was collected from each participant, placed in a gel tube and left to coagulate. Serum was isolated using a centrifuge and stored at -20 °C. HbA1c levels were measured using a Cobas c311 device, micro albumin levels using an Abbott device, and lipid and electrolytes levels using a Cobas c311 device.
Results: The study results showed a balanced distribution between genders (P=0.572). There were significant differences between age groups, with the age group <10 years accounting for 20% and >10 years 80% (p<0.0001). Regarding body mass index (BMI), 60% of individuals were below normal weight and 27% were in the normal range (P< 0.0001). The proportion of uncontrolled diabetes was 87% (HbA1c ≥7.5) versus 13% of controlled diabetes (p<0.0001). Urinary albumin levels were normal in 75% of patients and 25% had microalbuminuria (p<0.0001). There were no significant differences between genders in diabetes control (P=0.438). The study showed that diabetes control was higher in the age group less than 10 years compared to the older group (p<0.0001). There was no significant difference in diabetes control between the different BMI categories (P=0.871). HbA1c levels and albuminuria were higher in patients with uncontrolled diabetes (p<0.0001). There were no significant differences in the levels of other indicators such as cholesterol, sodium and potassium (p>0.05).
Conclusions: The study showed that uncontrolled diabetes is associated with increased HbA1c levels and albuminuria, which indicates worsening kidney function. Variation in diabetes control between age and BMI groups reflects the influence of age and weight factors on metabolism and response to treatment. Highlights the importance of careful medical follow-up for patients.