Optimized health care for subjects with type 1 diabetes in a resource constraint society: A three-year follow-up study from Pakistan

Table 1 Baseline demographic and clinical characteristic of study subjects

Variables	0-5 yr	6-12 yr	13-18 yr	19 and above
n (%)	103 (7.21)	323 (22.62)	428 (29.97)	574 (40.2)
Male	50 (48.5)	155 (48)	251 (58.6)	334 (58.2)
Female	53 (51.5)	168 (52)	177 (41.4)	240 (41.8)
Age at diagnosis (yr)	3.2 ± 1.5	8.3 ± 2.5	13.7 ± 3.6	22 ± 6.3
Age at recruitment (yr)	3.5 ± 1.5	9.5 ± 1.9	15.6 ± 1.7	25.7 ± 5.5
Duration of diabetes (yr)	0.3 ± 0.7	1.1 ± 2	1.9 ± 3.3	3.7 ± 5.4
Family history of diabetes	37 (35.9)	131 (40.6)	199 (46.5)	276 (48.1)
Weight (kg)	13.90 ± 2.61	28.31 ± 13.01	42.86 ± 10.64	53.11 ± 10.34
Serum Creatinine (mg/dL)	0.64 ± 0.18	0.80 ± 0.19	0.94 ± 0.43	0.92 ± 0.31
Cholesterol (mg/dL)	---	153.67 ± 33.06	155.63 ± 40.01	163.18 ± 28.58
Triglyceride (mg/dL)	---	83.25 ± 42.96	103.47 ± 73.66	94.46 ± 60.24
High density lipoproteins (mg/dL)	---	39.48 ± 12.21	42.46 ± 11.73	41.52 ± 10.45
Low density lipoproteins (mg/dL)	---	79.70 ± 26.07	86.34 ± 30.67	98.94 ± 30.44

Data presented as mean ± SD and n (%).

Table 2 Comparison of clinical measures from baseline to last follow up

Variables		Age (yr)
		0-5 yr	6-12 yr	13-18 yr	19 and above
HbA1c (%)	Baseline (n = 1428)	11.5 ± 2.04	10.7 ± 2.28	10.5 ± 2.76	9.6 ± 2.52
	End line (n = 516)	10.2 ± 2.12	8.9 ± 2.24	8.7 ± 2.49	8.5 ± 2.17
	P-value	0.026	< 0.0001	< 0.0001	< 0.0001
Systolic blood pressure (mmHg)	Baseline (n = 1428)	108.3 ± 20.8	105.4 ± 14.7	106.3 ± 14.7	108.2 ± 14.9
	End line (n = 1428)	92.4 ± 10.3	99.1 ± 13.3	105.3 ± 13.3	112.7 ± 14.2
	P-value	0.001	0.0002	0.500	0.001
Diastolic blood pressure (mmHg)	Baseline (n = 1428)	74.6 ± 11.2	72.9 ± 10.6	73.7 ± 10.5	74.3 ± 10
	End line (n = 1428)	65 ± 6.6	66.2 ± 7.7	71.3 ± 8.3	74.6 ± 8.5
	P-value	0.001	0.0004	0.002	0.747
Fasting blood sugar (mg/dL)	Baseline (n = 1428)	199.2 ± 109.4	266.4 ± 118.9	282.4 ± 107	266.20 ± 112.6
	End line (n = 1428)	77.0 ± 2.64	293.86 ± 105.57	270.96 ± 104.83	252.43 ± 117.13
	P-value	0.059	0.292	0.550	0.415
Random Blood Sugar (mg/dl)	Baseline (n = 1428)	326.2 ± 161.1	342.4 ± 149.7	360.3 ± 135.4	338.9 ± 131
	End line (n = 1428)	522.33 ± 267.54	479.24 ± 189.99	394.63 ± 171.36	354.86 ± 157.43
	P-value	0.002	<0.0001	0.138	0.476

Data presented as mean ± SD.

Table 3 Age distributed glycemic status on first and last visit of the study period

	Age (yr)
Glycemic category	0-5 yr		6-12 yr		13-18 yr		19 and above
	Baselinevisit	Lastvisit	Baselinevisit	Last visit	Baselinevisit	Last visit	Baselinevisit	Last visit
Good glycemic control (HbA1c < 6.5%-8%)	3.6	25.9	13.5	36.3	14.7	37.7	26.8	62.1
Fair glycemic control (HbA1c 9%-10%)	14.3	40.7	16.2	19.1	14.7	14	26.8	12.4
Poor glycemic control (HbA1c ≥ 10%)	82.1	33.3	70.3	44.5	70.7	48	46.5	25.5

Data presented as percentages (%).

Table 4 Trends of mean self-monitoring blood glucose readings during the study period

Timing	Month 1	Year 1 (month 2-12)	Year 2(month 13-24)	Year 3(month 25-36)
Before breakfast
0-5 yr	213.5	202.6	184.1	150.9
6-12 yr	197.3	173.6	193.1	146.2
13-18 yr	180.3	169.9	168.3	137.8
19 and above	163.2	151.5	139.6	138
After 2 h of breakfast
0-5 yr	328.5	246.9	167.7	194
6-12 yr	215.5	209.5	203.5	190.3
13-18 yr	232.5	203.5	215.5	173.8
19 and above	200.3	178.6	166.2	184.6
Before lunch
0-5 yr	248.2	265.8	132.3	140.2
6-12 yr	180.1	191.2	194.3	184
13-18 yr	200.3	189.7	192.8	148.9
19 and above	164	160.2	147.4	151.7
After 2 h of lunch
0-5 yr	281.6	252.2	204.7	257.5
6-12 yr	269.8	226.8	237.3	207.6
13-18 yr	246.6	230.6	237.4	194.8
19 and above	223.1	211.8	202.8	203.8
Before dinner
0-5 yr	299.2	276	216.2	239.9
6-12 yr	262	261.1	242.6	218.1
13-18 yr	255	228.4	234	205.5
19 and above	223.6	191.8	211.4	182.1
After 2 h of dinner
0-5 yr	297.3	254.3	196.8	239.8
6-12 yr	239.3	247.8	244.7	192.5
13-18 yr	240.1	219.2	213.7	179.8
19 and above	217.4	195.9	212.1	180.7
Before sleeping
0-5 yr	273.3	254.9	212.5	214.7
6-12 yr	230.7	230.6	181.1	211.3
13-18 yr	195	223.3	218.8	165.7
19 and above	167.3	167.9	196.4	195