Comparative Study of Clinico-demographic Characteristics and Glycemic Control in Urban and Rural Children with Type 1 Diabetes Mellitus

Objectives: Type 1 Diabetes Mellitus (T1DM) is quite prevalent and common and has been rising at an average rate of 3%-4% a year in children and adolescents. Hence, this study was conducted with the aim of comparing the socio-demographic and clinical profiles between urban and rural children focusing primarily on glycemic control and complications. Material and Methods: A cross-sectional study was conducted among children with type 1 diabetes in a tertiary care hospital in Tamil Nadu. The study was conducted over 9 months. Data were collected using a pre-designed, pre-tested, semi-structured interview schedule based on the Tamil Nadu Type 1 Diabetes Registry. The participants or their informants were interviewed to elicit information on their socio-demographic profile and individual characteristics such as age of onset of diabetes, area of residence, environmental disruptors near home, food habits, birth details, glucose levels, and hemoglobin A1c (HbA1C) at diagnosis, current insulin regimen, total dose of insulin required, and complications such as diabetic ketoacidosis and hypoglycemic episodes. Data collected were entered into an Excel sheet and analyzed using Statistical Package for the Social Sciences version 20.0. Differences between means and standard deviations were expressed using independent samples t-tests. Results: This cross-sectional study was conducted among 320 children. The study found that the incidence of T1DM was higher in female children. The mean glucose level at the time of diagnosis was 480.4 ± 111.8 mg/dL, and the mean HbA1C value at the time of diagnosis was 12.7% ± 2.8%. Around 56% of children had HbA1C levels higher than 10% at the time of diagnosis, and 11% of children had HbA1C between 6.5% and 10%. 32% of children did not have baseline values. The mean difference between the urban and rural populations for various variables was statistically significant only for HbA1C pre-pump and hypoglycemic episodes. The difference in annual income between the urban and rural populations was also significant. Conclusion: Rural children are performing as good as the urban children in T1DM management. Most of the rural children are economically deprived in terms of annual parental income; however, they are on par with urban children in terms of glycemic control.