[Glicemic control in prepubertal and pubertal patients with diabetes type 1 - a one year ambulatory follow-up]

OBJECTIVE: To evaluate glycemic control in type 1 diabetes mellitus patients followed in 1998. PATIENTS AND METHODS: We studied 38 patients [22 males; age = 10.4 -/+ 4.1 years; 12 (31.6%) prepubertal, 26 (68.4%) pubertal], with diabetes duration of 3.7-/+3.4 years and age of diagnosis of 7.2 -/+ 4.7 years. HbA1c was determined using high-performance liquid chromatography (L-9100 Merck Hitachi, reference value =2.6 to 6.2%). RESULTS: HbA1c was 8.04 -/+ 2.4%, without association with gender and puberty. In the 27 patients with at least two HbA1c determinations, the level of glycemic control changed in 8 (29.6%) and remained the same in 19 (70.4%). From these, glycemic control was poor in 3 (11.1%) and good in 16 (59.3%). Among the patients with good glycemic control, HbA1c was always within reference values in 4 (25%); 7 (43.75%) had at least one HbA1c measurement within these limits; and in 5 (31.25%), all HbA1c measurements were above the upper limit of the reference range. There was no association between the last glycemic control evaluation and the number of HbA1c determinations. The intraindividual coefficient of variation of HbA1c in the group that had at least three HbA1c determinations (n = 19) was 11.2 -/+ 5.6% (P = 0.0000). CONCLUSION: In our study, although most patients presented satisfactory glycemic control during the follow-up period, only 4 patients (14.8%) maintained normal values of HbA1c. The variability of HbA1c must be evaluated when considering the interrelation between glycemic control and evolution to microvascular complications in diabetis.