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Abstract

  Background: Poor glycemic control continues to be a major concern in pediatric type 1 diabetes mellitus (T1DM). This study has examined the sociodemographic, behavioral, and clinical factors that are associated with uncontrolled glycemia in children with T1DM.

  Methods: We conducted a cross-sectional study of 309 patients withT1DM patients under the age of 18 years. The sample population was recruited at the diabetes outpatient departments and inpatient wards of pediatric teaching hospitals in Sulaymaniyah and Erbil. HbA1c of ≤ 7.5% was considered as good glycemic control.

  Results: The vast majority of participants (87.1%) had uncontrolled glycemia, highlighting a substantial gap in effective glucose management within this population. In multivariable logistic regression, each 1-year increase in age was associated with 15% higher odds of poor glycemic control (AOR 1.153; 95% CI 1.023–1.307; p = 0.019). Low socioeconomic status was associated with markedly higher odds of poor glycemic control compared with high socioeconomic status (AOR 6.848; 95% CI 1.487–65.957; p = 0.011). Lack of regular physical activity was also associated with increased odds (AOR 2.514; 95% CI 1.123–5.579; p = 0.025). There were no statistically significant relationships between glycemic status and sex, BMI, residence, dietary adherence, follow-up visit or insulin regimen.

  Conclusion: Most children with T1DM did not achieve glycemic goals, especially adolescents and children with lower socioeconomic status. The sociodemographic factors and certain modifiable behaviors were more strongly associated with glycemic control than insulin therapy regimens, and this highlights the necessity of specific multifaceted interventions to the high-risk groups.

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