Clinical and biochemical features at diagnosis of type 1 diabetes in patients between 0 and 18 years of age from Jordan

Odeh, Rasha; Alassaf, Abeer; Ajlouni, Kamel

doi:10.1111/pedi.12625

Cited by 4 publications

(4 citation statements)

References 32 publications

(64 reference statements)

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“…In our analysis, the DKA rate at manifestation of T1D in children and adolescents under 16 years of age was 31.7%. This rate is almost 10% less than our previously reported rate of 40.7% ( 14 ). This could be due to the fact that we are reporting from a tertiary hospital with an established pediatric diabetes practice which resulted in good awareness and the prompt recognition of diabetes symptoms.…”

Section: Discussioncontrasting

confidence: 72%

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Frequency, Clinical Characteristics and Predictors of Ketoacidosis at Diagnosis of Type One Diabetes Mellitus in Children and Adolescents from Jordan

Odeh¹,

Gharaibeh²,

Daher³

et al. 2023

Jcrpe

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Objective: Data regarding diabetic ketoacidosis (DKA) at diagnosis of type one diabetes (T1D) in developing countries are scarce. The aim of this study was to describe the frequency of DKA at the onset of T1D in children and adolescents in Jordan and to compare the clinical and biochemical characteristics between the group that presented with DKA and the group that did not. Methods: The records of 341 children and adolescents, less than sixteen years of age, who were diagnosed with T1D between 2015 and 2019 were evaluated retrospectively. Results: Of all the children diagnosed with T1D, 108 (31.7%) presented with DKA. The majority had mild or moderate DKA (38% and 33.3% respectively). Higher paternal education levels were associated with a lower probability of presenting with DKA (p=0.043). A family history of T1D had a protective effect on the occurrence of DKA (Odds ratio=2.138; 95% confidence interval=1.167-3.917, p=0.014). Patients with celiac disease and higher HbA1c levels were more likely to experience recurrent episodes of DKA, (p=0.004 and 0.011, respectively). Conclusion: In Jordan, the rate of DKA at presentation of T1D remains high. Prevention campaigns are needed to increase diabetes awareness among the public and healthcare providers.

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Section: Discussioncontrasting

confidence: 72%

“…Data from the middle eastern region are scarce and a systematic review by Zayed ( 13 ) showed DKA rates between 17% and 100% at the time of T1D diagnosis in various middle eastern countries. In Jordan, we previously reported a DKA rate of 40.7% at the time of T1D diagnosis ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Frequency, Clinical Characteristics and Predictors of Ketoacidosis at Diagnosis of Type One Diabetes Mellitus in Children and Adolescents from Jordan

Odeh¹,

Gharaibeh²,

Daher³

et al. 2023

Jcrpe

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“…As Jordan has limited resources and is considered a middle income country [6], healthcare professionals face many challenges in providing comprehensive care for patients with type 1 diabetes (T1D). For example, the majority of paediatric patients, who present at diagnosis of T1D to the public hospitals in Jordan, are started on premixed insulin and reimbursement for self-monitoring of blood glucose is very limited [7]. The paediatric endocrinology clinic at Jordan University Hospital (JUH) was established in 2012 under the care of two full time paediatric endocrinologists where almost all T1D patients are started or switched to the basal-bolus regimen with self-monitoring of blood glucose.…”

Section: Introductionmentioning

confidence: 99%

Caring for a child with type 1 diabetes during COVID-19 lockdown in a developing country: Challenges and parents’ perspectives on the use of telemedicine

Odeh

Gharaibeh

Daher

et al. 2020

Diabetes Research and Clinical Practice

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Background and Aim: Jordan implemented abrupt and extreme lockdown measures to prevent the spread of COVID-19. This study aims to evaluate the effect of these measures on paediatric patients with type 1 diabetes in terms of acute metabolic complications and shortages in insulin and glucose measuring supplies. It also evaluates the caregivers' perceptions of the use of telemedicine during the lockdown. Methods: This is a questionnaire-based cross-sectional study. It was completed using Google forms and patients/caregivers were asked to consent if they agreed to answer. Results: 235 patients/families participated in the study. The mean age of the patients was 10.8 years ± 3.9 years (N = 229). Twenty-four children (10.2%) needed to visit the emergency department during the lockdown period which lasted for 10 weeks. Of these, eight (3.4%) were hospitalized due to acute metabolic complications. Families (58.3%) faced insulin shortages and 14% had to ration insulin, i.e., decrease the dose, during the lockdown. Glucose monitoring strips were rationed by 43.4% of families leading to more frequent low/ high glucose readings in 75.5% of children of these families. Telemedicine using phones and social media applications was utilized for communication with healthcare professionals and continuing medical care. Most of the participants (85.5%) described it as a smooth and positive experience. Conclusions: The extreme lockdown due to COVID-19 pandemic caused insulin and glucose measuring equipment shortages in children with diabetes in Jordan. However, the use of telemedicine for providing guidance and support was perceived positively by the families.

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“…Our study also exhibited similar results, with an HbA1c mean of 11.34±1.77 in severe DKA being significantly higher than 10.80±1.93 in moderate DKA (p=0.038). Odeh et al reported that HbA1c level correlated with the patients’ age and was significantly higher in patients of 11 years of age or older (12.0±1.9 vs. 11.2±20 and 10.3±1.8, respectively; p=0.001), whereas it did not differ by sex [ 21 ]. This indicates that poor glycemic control and higher HbA1c levels are more likely to result into severe DKA.…”

Section: Discussionmentioning

confidence: 99%

A Clinical and Biochemical Comparative Study Of Diabetic Ketoacidosis (DKA) in Newly Diagnosed Vs Known Cases of Type 1 Diabetic Children

Albuali

Yousef

Al-Qurashi

et al. 2023

Review of Diabetic Studies

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Objectives: We aimed to study the characterizing clinical and biochemical profiles of Diabetic Ketoacidosis (DKA) in children with newly diagnosed Type 1 Diabetes Mellitus (Type 1DM) compared to children with established diagnosis of Type 1DM presenting with DKA admitted to the pediatric intensive care unit of a large university hospital in the eastern region of Saudi Arabia. Methods: We retrospectively reviewed the medical records of 211 patients who were admitted to the pediatric intensive care unit with diabetic ketoacidosis between 2010 and 2019. The diagnosis of diabetic ketoacidosis was based on symptoms of polydipsia, polyurea, weight loss, vomiting, dehydration, abdominal pain, breathing problems, lethargy or coma, biochemical hyperglycemia (blood glucose level of >200 mg/dL), venous pH of <7.3, serum bicarbonate level of ≤15 mEq/L, and ketonemia (blood β -hydroxybutyrate concentration of ≥3 mM) or moderate or severe ketonuria (diagnosed as newly acquired type 1 diabetes). Results: The rate of newly diagnosed Type 1 DM with DKA was 41.7%, out of them who got severe and moderate diabetic ketoacidosis were 61.6% and 38.4%, respectively. We observed significantly increased heart and respiratory rates in patients newly diagnosed with diabetic ketoacidosis and in those with severe diabetic ketoacidosis (p<0.001) compared to known cases with Type 1DM presenting with DKA. We also identified significantly increased biochemical indices including HbA1c, random blood sugar, serum osmolality, blood urea nitrogen, creatinine, chloride, lactate, and anion gap in relation to severe diabetic ketoacidosis and newly diagnosed type 1 diabetes (p ≤ 0.05). Conclusions: We found that the clinical and biochemical profiles of patients with newly diagnosed Type 1 DM children were significantly affected compared to children who were known Type 1DM presenting with DKA.

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Clinical and biochemical features at diagnosis of type 1 diabetes in patients between 0 and 18 years of age from Jordan

Abstract: The findings possibly indicate a decreasing age of T1D onset in Jordanian patients. The high frequency of ketoacidosis at presentation is noteworthy. In addition, the initial insulin protocols are not in accordance with the recommended insulin therapy for children and adolescents with T1D.

Cited by 4 publications

References 32 publications

Frequency, Clinical Characteristics and Predictors of Ketoacidosis at Diagnosis of Type One Diabetes Mellitus in Children and Adolescents from Jordan

Frequency, Clinical Characteristics and Predictors of Ketoacidosis at Diagnosis of Type One Diabetes Mellitus in Children and Adolescents from Jordan

Caring for a child with type 1 diabetes during COVID-19 lockdown in a developing country: Challenges and parents’ perspectives on the use of telemedicine

A Clinical and Biochemical Comparative Study Of Diabetic Ketoacidosis (DKA) in Newly Diagnosed Vs Known Cases of Type 1 Diabetic Children

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