Time to First Optimal Glycemic Control and its Predictors Among Type 1 Diabetic Children<15 Years in Bahir Dar City Public Referral Hospitals, North West Ethiopia: A Retrospective Follow Up Study

Background: Recognizing the level of glycemic control of a client is an important predictor of the development of complication and risk of death from diabetes. However, the other most important predictor which is the time that the patient stayed in that poor glycemic level before reaching optimal glycemic control has not been studied so far. Objective: The aim of this study was to estimate time to first optimal glycemic control and identify predictors among type 1 diabetic children<15 years in Bahir Dar city public referral hospitals, Northwest, Ethiopia, 2021 Methods: Retrospective cohort study was conducted at Bahir Dar city public referral hospitals among randomly selected sample of 385 patients with type 1 diabetes who were on follow up from January1, 2016 to February30, 2021.Data were collected by using data abstraction tool and then entered into Epi-data version 4.2 and exported into STATA 14.0 statistical software. Descriptive statistics, Kaplan Meier plots and median survival times, Log-rank test and Cox-proportional hazard regression were used for analysis. After performing Cox-proportional hazard regression, model goodness-of-fit and assumptions were checked. Finally, association between independent variables and time to first optimal glycemic control in months were assessed using multivariable Cox Proportional Hazard model and Variables with p-value < 0.05 were considered as statistically significant. Result: Median survival time to first optimal glycemic control among type 1 diabetic client was 8 months (95%CI: 6.9-8.9).First optimal glycemic achievement rate was 8.2(95%CI: 7.2-9.2) per 100 person/month observation. Factors that affect time to first optimal glycemic control were age (AHR=0.32;95%CI=0.19-0.55),weight(AHR=0.96;95%CI=0.94-0.99),primary care giver(AHR=2.09;95%CI=1.39-3.13), insulin dose (AHR=1.05;95%CI=1.03-1.08),duration of diabetes (AHR=0.64;95%CI=0.44-0.94), adherence (AHR=9.72;95%CI=6.09-15.51),carbohydrate counting(AHR=2.43;95%CI=1.12-5.26),and comorbidity (AHR=0.72;95%CI=0.53-0.98). Conclusion: and Recommendation: The median survival time to first optimal glycemic control in this study was long. Age, weight, primary care giver, insulin dose, duration of diabetes, adherence, and carbohydrate counting including history of comorbidity were determinant factors. Therefore, clinicians should advice weight reduction, increase the dose of insulin during initial treatment, counsel their parents about adherence of insulin drug and auditing their children diet as prescription helps to reduce the length of glycemic control.