Comparison of Body Composition Bio Electrical Impedance Analysis of Type-1 Diabetes vs. Non-Diabetes in Children and Adolescent

Background: Analyzing the body composition of children and adolescents with diabetes is becoming more and more popular. For managing weight changes that may emerge from treatment and evaluating treatment response, it is essential to comprehend the body composition of diabetic children. Objective: To compare body composition by Bioelectrical Impedance Analysis (BIA) among T1DM versus healthy children and adolescents in Pakistan. Methods: This comparative cross-sectional study was performed during Jan-March, 2023. Type 1 diabetic children and adolescents were enrolled from the pediatric endocrinology outpatient clinic of the National Institute of Child Health whereas healthy children and adolescents were enrolled from a nearby school to the hospital location. Evaluation of anthropometry indices and bioelectrical impedance analysis was performed after obtaining the consent of parents. Results: A total of 100 subjects were enrolled in the study, 50 each in the diabetic and healthy group. The mean age of participants was 10.4 ± 2.4 years. The majority of study subjects were females (61%). The mean duration of T1DM was 4.7 ± 0.8 years. Height (127.4 ± 11.7 versus 139.5 ± 15, p<0.001), Waist-hip ratio (0.8 ± 0.1 versus 0.7± 0.3, p=0.037) and resistance (686.2 ± 90.7 versus 651.1 ± 96.6, p=0.002) were significantly higher among T1DM group than healthy group. Percentage of muscle mass (45.1 ± 8.2 versus 50.3 ± 7.6, p=0.008), body cell mass (47.1 ± 3.8 versus 50.6 ± 4.5, p=0.045), reactance (56.3 ± 9.8 versus 62.4 ± 4.2, p=0.017) and phase angle (4.3 ± 0.9 versus 5.7 ± 0.6, p=0.012) were significantly lower in T1DM patients than healthy individuals. Conclusion: BIA analysis showed that body composition parameters and body functional status were lower among T1DM children and adolescents than in the healthy group in terms of resistance, reactance, and phase angle

Bone Mineral Density in Children with Congenital Adrenal Hyperplasia

Background: Treatment in all forms of Congenital Adrenal Hyperplasia (CAH) includes lifelong replacement of steroids. Steroids have an impact on bone health in multiple ways and are known to cause osteoporosis when given in high doses or for a longer duration. Objective: To evaluate bone mineral density (BMD), using dual-energy X-ray absorptiometry (DEXA) scan in children with CAH taking long-term steroids presenting in the pediatric endocrinology ward of National Institute of Child Health, (NICH) Karachi, Pakistan. Materials and Methods: This cross-sectional study was performed at the Department of Pediatric Endocrinology, National Institute of Child Health, Karachi from October 2021 to July 2022. A total of 47 diagnosed cases of CAH taking steroids for more than 5 years were enrolled. Assessment of BMD was done using a DEXA scan. Lumbar spine BMD was done and Z-score was modified for height for age z-score. The dose of steroids and duration was calculated. Results: Out of 47 patients, low BMD was observed in 8 (17.02%) patients. Individuals with low BMD had significantly higher median duration, (p=0.017), dose (p=0.003), and median alkaline phosphate level (p=0.036),) but low median BMD value (p=0.009) and z score (p<0.001) than normal BMD individuals. Although median bone age (p=0.009) was appropriate for chronologic age in low BMD patients. A moderate negative significant correlation was observed between z score and age (rho=-0.319, p=0.029), z-score and duration of steroid treatment (rho=-0.364, p=0.012), z score and alkaline phosphate (rho=-0.466, p=0.001), z score and bone age (rho=-0.378, p=0.009). Conclusion: Low BMD was observed in 17% of children on the DEXA scan. Moreover, these individuals had significantly higher median average duration and dose of hydrocortisone

Growth Characteristics in Children with Congenital Adrenal Hyperplasia Visiting Tertiary Care Hospital, Karachi

Objective: To determine the growth characteristics in children with congenital adrenal hyperplasia visiting tertiary care hospital Karachi. Study Design: Cross-Sectional study. Place and Duration of Study: Paediatrics Department, National Institute of Child Health, Karachi Pakistan, from Nov 2018 to May 2019. Methodology: All patients who visited the OPD were included in the study. Growth characteristics like underweight, normal BMI, overweight, obese and short stature were recorded. This information, along with the age of diagnosis, family history of CAH, parental consanguinity, family history of CAH or any abortion or prenatal death, were noted. Results: The mean age of the patients was 7.40±2.34 years. Out of 69 congenital adrenal hyperplasia patients, 41(59.4%) were males, and 28(40.6%) were females. The short suture was noted in 53(76.8%) patients. 19(27.5%) were underweight, 6(8.7%) were normal weight, 10(14.5%) were overweight, and 34(49.3%) patients w ere obese. Conclusion: A significant effect of congenital adrenal hyperplasia was documented in the children

FACTORS AFFECTING GLYCEMIC CONTROL IN TYPE-1 DIABETIC CHILDREN AT PAEDIATRIC DIABETIC OPD, CIVIL HOSPITAL HYDERABAD

Objective: To assess the factors affecting Glycemic Control in Type-1 Diabetic children at Paediatric Diabetic OPD, Civil Hospital Hyderabad Methodology: ThisObservational study was done at Pediatrics Diabetic OPD, Civil Hospital Hyderabad, total 6 Monthduration from 1st April 2015 to 30 September 2015 in 80 Diabetes children of age 1 year to 15 years of both genders. Results: A total of 80 children were selected in this study. Majority of subjects belonged to 5 to 12 years age group (p=0.0001). Great, reasonable and terrible glycemic control was noted in 14 (17.5%), 17 (21.2%) and 49 (61.2%) separately (p=0.0001). In this examination, the majority of the patients, for example, 66.25% were found in the age aggregate 5 to12 years with male and female and they were similarly influenced. 37.5% were known diabetic. Polyuria, Polydipsia, Polyphagia was prevalent component. The majority of the patients for example half glucose control was not ideal (Blood Sugar Level Greater than 360mg). Dominant part of patients were underweight/malnourished Females were increasingly influenced. It was seen that greater part of patients were short in stature and females were progressively influenced. Conclusion: In our investigation insulin treatment is the backbone of treatment and poor consistence of insulin were the significant hazard factor for uncontrolled diabetes and complexities. It was noted in this examination that lion's share of patients were not ready to perceive/separate sort of insulin infusions and were uninformed about hypoglycemia and its treatment at home. Dominant part were taking illegal nourishments (sweet). Keywords:Glycemic Control, Type 1 Diabetes Mellitus, Blood glucose