Research

Characteristics of children presenting with newly diagnosed type 1 diabetes

Yavini Reddy, Yasmeen Ganie, Kuben Pillay

Abstract


Background. The clinical presentation of type 1 diabetes in children can be acute or insidious, and symptoms may be subtle and frequently misinterpreted. Presentation with diabetic keto-acidosis (DKA) may be associated with significant morbidity and mortality in the paediatric population. This study set out to determine the characteristics of children presenting to the paediatric endocrine service at Inkosi Albert Luthuli Central Hospital (IALCH) with DKA at the time of diagnosis, and to determine the frequency of missed diagnoses in the previous month.

Methods. A retrospective study was done at IALCH, the paediatric tertiary referral centre for KwaZulu-Natal, South Africa. The study sample included all children with an initial diagnosis of type 1 diabetes between January 2008 and June 2010. Children presenting with DKA were compared with those who presented without DKA.

Results. During the period under review, 63 children presented with type 1 diabetes. Of these, 44 (69.8%) had DKA at the time of diagnosis. The median duration of symptoms preceding diagnosis in the DKA group was 2 weeks, versus 4 weeks in the non-DKA group (p=0.002). There was no significant difference between the groups when ethnicity, gender and age at presentation were compared. Of 42 patients who presented to healthcare facilities in the month preceding diagnosis, 27 (64.3%) were misdiagnosed.

Conclusion. Patients who presented with DKA had a shorter duration of symptoms than the non-DKA group. Ethnicity had no effect on characteristics at presentation. There was an unacceptable rate of missed diagnoses of type 1 diabetes in both the private and public sectors.


Authors' affiliations

Yavini Reddy, Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, Faculty of Health Sciences, University of KwaZulu Natal, Durban, South Africa; Division of Paediatric Endocrinology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa

Yasmeen Ganie, Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, Faculty of Health Sciences, University of KwaZulu Natal, Durban, South Africa; Division of Paediatric Endocrinology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa

Kuben Pillay, Division of Paediatric Endocrinology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; Centre for Paediatric Endocrinology and Diabetes, Westville Hospital, Durban, South Africa

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Keywords

type 1 diabetes, diabetic ketoacidosis, child health

Cite this article

South African Journal of Child Health 2013;7(2):46-48. DOI:10.7196/SAJCH.500

Article History

Date submitted: 2013-01-03
Date published: 2013-05-20

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