Impact of a pioneer diabetes camp experience on glycemic control among children and adolescents living with type 1 diabetes in sub-Saharan Africa.

BACKGROUND: The metabolic impact of participating in a diabetes camp is little known among children and adolescents living with type 1 diabetes in sub-Saharan Africa. We aimed to assess the changes in glycemic control and insulin doses in a group of children and adolescents living with type 1 diabetes in Cameroon during and after camp attendance. METHODS: During a 5-day camp, we collected data on insulin doses, HbA1c, weight and blood glucose at least six times per day in a group of children and adolescents living with type 1 diabetes. We compared the evolution of these parameters 3 and 12 months after camp. RESULTS: Thirty-two campers completed the study. The mean age was 19 ± 2 years and the median duration of diabetes was 2 [IQR: 1.8-5] years. The mean HbA1c was 7.9 ± 2.2 % and the mean insulin dose was 49 ± 20 units/day upon arrival at camp. HbA1c dropped by 0.6 % after 12 months (p = 0.029). Despite the significant (p = 0.04) reduction in insulin dose from 49 ± 20 to 44 ± 18 units/day at the end of camp, hypoglycemic episodes occurred in 26 campers. However, the mean number of hypoglycemic episodes reduced from 1.32 (range: 0-4) on the first day, to 0.54 (range: 0-2) on the last day of camp (p = 0.006). Weight increased by 6 kg (p = 0.028) between 3 and 12 months after camp, but insulin doses remained unchanged. CONCLUSIONS: Attending camp for children and adolescents living with diabetes is associated with a significant decrease in HbA1c twelve months after camp without changes in insulin doses. Including camps as an integral part of type 1 diabetes management in children and adolescents in sub-Saharan Africa may yield some benefits. TRIAL REGISTRATION: ClinicalTrials.gov NCT02632032 . Registered 4 December 2015.

The effect of free diabetes care on metabolic control and on health-related quality of life among youths with type 1 diabetes in Cameroon.

OBJECTIVE: To assess the effect of free diabetes care on metabolic control and on health-related quality of life (HRQoL) of youths living with type 1 diabetes in Cameroon. RESEARCH DESIGN AND METHODS: We conducted a clinical audit of a multicenter prospective cohort, performed in three of the nine clinics of the 'Changing Diabetes in Children' (CDiC) project in Cameroon. We collected data on demography, glycemic control, diabetes acute complications, and patients' HRQoL at baseline and after 1 year of follow-up. RESULTS: One hundred and four patients (51 female) were included. The mean age was 16±2 years (min-max: 9-18), the mean duration of diabetes was 5±3 years, and the mean HbA1C level was 11.4%±2.7%. A significant reduction in HbA1c (11.4%±2.7% vs 8.7±2.4%), episodes of severe hypoglycemia (27/104 vs 15/104), and episodes of ketoacidosis (31/104 vs 7/104) were observed after 1 year (p<0.05). We did not observe any significant difference in the total HRQoL score (p=0.66). However, we observed a significant decrease in diabetes-associated symptoms (p<0.05). Age, level of education, duration of diabetes, glycemic control, and the presence or absence of diabetes complications did not significantly affect the total HRQoL score. CONCLUSIONS: One year after free diabetes care offered through the CDiC project, a significant improvement was observed in glycemic control and acute complications of diabetes, but not in the total score of HRQoL of youths living with type 1 diabetes enrolled in the project.