Epidemiological Pattern of Newly Diagnosed Children with Type 1 Diabetes Mellitus, Taif, Saudi Arabia

Abstract

Introduction and Aim. Type-1-diabetes mellitus (T1DM) is the most commonly diagnosed type of DM in children and adolescents. We aim to identify the epidemiological profile, risk factors, clinical features, and factors related to delayed diagnosis or mismanagement in children with newly diagnosed T1DM in Taif, Saudi Arabia. Patients and Methods. Ninety-nine newly diagnosed patients were included in the study along with 110 healthy controls. Patients were classified into 3 groups (I: >2 years, II: 2–>6 years, and III: 6–12 years). Both patients and controls were tested for C-peptide, TSH, and autoantibodies associated with DM and those attacking the thyroid gland. Results. Diabetic ketoacidosis was present in 79.8%. Delayed and missed diagnoses were recorded in 45.5%, with significant correlation to age and district of origin. Severity at presentation showed significant correlation with age and cow's milk feeding. Group I, those with misdiagnosis or positive DM related autoantibodies, had more severe presentations. The correlation of C-peptide and TSH levels in patients and controls was significant for C-peptide and nonsignificant for TSH. Conclusion. Misdiagnosis and mismanagement are common and account for more severe presentation, especially in young children >2 years. Early introduction of cow's milk appears to be a risk factor for the development of T1DM.

Epidemiology of diabetic ketoacidosis in Arab patients with type 1 diabetes: a systematic review

“…The frequency of DKA among Arabs ranges from a low of 17% in Egypt (20) to a high of 100% in Algeria (21), Morocco (22) and Tunisia (23). Saudi Arabia represents most of the T1D patients with 36.3% of the total number of patients with DKA frequency ranging from 25% to 80% (Table 1) (14,(24)(25)(26)(27)(28)(29)(30), followed by Egypt with 23.8% of T1D patients and DKA frequency of 17-61% (Table 2)…”

Clinical Profile of Type 1 Diabetes Mellitus in Saudi Children: a Hospital Based Study

“…Studies revealed different clinical symptoms at onset of disease with varying frequency like dry sensation in mouth (95%), polydipsia (84%), polyuria (65%), weight loss (49%) and nocturia (27%). 8,9 Diabetic children are more prone to develop DKA as compared to adults. This severe metabolic imbalance carries high morbidity and mortality in children.…”

DKA as initial presentation in children with Type 1 diabetes mellitus-risk factors: a case control study

“…6 In a study done by Kamal Alanani et al observed that almost half of the children with DKA had delayed missed diagnosis. 7 Pawlowiczmet et al and PCB Sundaram et al observed DKA was significantly more frequent in children with delayed diagnosis. 8,9 In this study group 2/3 rd of children with DKA were referred early and started on specific treatment compared to T1DM children, because of the severity of illness.…”