Determinants of poor glycemic control in children with type 1 diabetes mellitus in Northwest Ethiopia

Poor glycemic control constitutes a major public health issue and a key risk factor for the development of diabetes related complications, disease-related healthcare expenses, lower life expectancy, and quality of life. There is a paucity of evidence on the level of Glycemic control and associated factors in the study setting. To assess the magnitude of poor Glycemic control and its associated factors among children with Type 1 diabetes mellitus on follow-up at Tibebe Ghion Specialized Hospital and Felege Hiwot Comprehensive Specialized Hospital, Bahirdar, Northwest-Ethiopia, 2024. A cross-sectional study was conducted from July to December 2024 at two tertiary hospitals in Northwest Ethiopia, involving 206 pediatric T1DM patients selected via random sampling. Data were collected using KoboToolbox by trained clinical staff and analyzed in SPSS v27. Descriptive statistics characterized the study participants, while binary and multivariable logistic regression models identified determinants of poor glycemic control. A total of 206 children with T1DM were included. Poor glycemic control was observed in 75.7% of participants. Children having a widowed caregiver were 11 times more likely to have poor glycemic control than children having married caregivers (AOR = 10.85; 95% CI: 2.6-45.06, P = 0.001). Similarly, children having a father as primary caregiver were 8 times more likely to have poor glycemic control compared to a mother as primary caregiver (AOR = 8.09; 95% CI: 2.7-24.17, p < 0.001). In addition to this, the odds of having poor glycemic control were 9 times higher among children who had a history of previous admission in the last six months as compared to children with no admission (AOR = 9.00; 95% CI: 3.5-23.17, p < 0.001). More than three-quarters of the study participants have poor glycemic control. Widowed, Divorced, and Single caregivers, Guardian and father caregivers, and those having admission in the previous 6 months were associated with poor glycemic control.