Glycaemic control among Bulgarian children and adolescents with type 1 diabetes-an impact of the social status and the educational level of the parents

Achievement of optimal glycaemic control in children and adolescents with type 1 diabetes depends on the knowledge of the patients and their parents about the control of the disease and the family support. The aim of this study was to investigate the importance of the social standard of the families determined by the employment of the parents and their educational qualification on the control of diabetes. Two consecutive national multi-centre cross-sectional studies of patients with type 1 diabetes, aged 0-19years, for HbA(1c) were conducted in 2012 and in 2014. The first study included 829 patients (422 boys, 407 girls), and the second - 498 patients; 281 patients participated in both studies. The patients whose parents are with primary education showed the highest level of HbA(1c) in both studies: 9.73% +/- 2.38% and 9.27% +/- 1.54% in the first, and the second study, respectively. The patients whose parents have university education achieved the best control: HbA(1c) is 8.45% +/- 1.76% and 7.84% +/- 1.24%, respectively. The cohorts of diabetic patients whose parents have secondary (p = 0.035) and university education (p < 0.001) showed significant reduction of HbA(1c) in the second study compared to the first one. The patients in families with unemployed parents or families in which only the mother is employed showed the highest levels of HbA(1c). Our results underline the importance of the educational qualification and the social standard of the family for the proper control of this chronic disease.