title: Ethnic differences in glycemic control and diabetic ketoacidosis rate among children with diabetes mellitus type 1 in the Negev area.
abstract: BACKGROUND
  The existent glycemic control of type 1 diabetes mellitus (T 1DM) patients in daily practice might not reach the goals determ ied in guidelines. Ethnic diversity was also shown to influence glycemic control.
  
  
  OBJECTIVE
  To evaluate glycemic control, prevalence of diabetic ketoacidosis (DKA) at presentation, diabetic complications rate, and associated autoimmune diseases in a pediatric Ti M patient population in the Negev area.
  
  
  METHODS
  Clinical and demographic details of 168 T1iDM patients were evaluated, including HbA1C levels, long-term complications, related autoimmune diseases, and insulin pump usage. The data were analyzed and the Jewish and Bedouin patient groups compared.
  
  
  RESULTS
  Only 13.1% of the patients had reached the HbA1C levels recommended by the current guidelines at the first and second year follow-up visits, and 9.5% and 7.1% at the third and fourth year visits, respectively. A significant difference in HbAlc levels between Jewish and Bedouin patients was found (P = 0.045 at the first year follow-up, P 0.01 thereafter). Significant difference was found between the Jewish and the Bedouin groups regarding presentation with DKA, 33% and 56% of the patients respectively (P= 0.01).
  
  
  CONCLUSIONS
  Existent glycemic control in daily practice is far from the guideline goals. Bedouin ethnicity was associated with less favorable diabetes control, emphasizing the need for better awareness of T1DM and its treatment options in this population. More resources should be directed to address T1DM in the general population, especially among the Bedouin.
authors.affiliation: Pediatric Endocrinology and Metabolism Unit, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Alnassara
authors.initials: A
authors.lastname: Hilmi
authors.forename: Yehonatan
authors.initials: Y
authors.lastname: Pasternak
authors.forename: Michael
authors.initials: M
authors.lastname: Friger
authors.forename: Neta
authors.initials: N
authors.lastname: Loewenthal
authors.forename: Alon
authors.initials: A
authors.lastname: Haim
authors.forename: Eli
authors.initials: E
authors.lastname: Hershkovitz
mesh_terms: D000293:Adolescent; D018912:Arabs; D001327:Autoimmune Diseases / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003431:Cross-Cultural Comparison; D018864:Cultural Diversity; D048909:Diabetes Complications / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology; D016883:Diabetic Ketoacidosis / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data; D007557:Israel / Q000453:epidemiology; D007585:Jews; D008019:Life Style / Q000208:ethnology; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods / Q000706:statistics & numerical data; D015995:Prevalence; D012959:Socioeconomic Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin