Trends of type 1 diabetes in Karachi, Pakistan

Shera, A. Samad; Miyan, Zahid; Basit, Abdul; Maqsood, Asma; Ahmadani, Mohammad Yakoob; Fawwad, Asher; Riaz, Mahwish

doi:10.1111/j.1399-5448.2007.00309.x

Cited by 8 publications

(11 citation statements)

References 20 publications

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“…37 The most common causes of diabetic ketoacidosis in children with established type 1 diabetes mellitus are the sudden cessation of subcutaneous insulin or the lack of monitoring. 38 In the present study, 60% of patients presented with disturbed mental status as evidenced by Glasgow Coma Scale scores <15. This can be explained by late referral of patients from peripheral hospitals to our tertiary hospital and supports the notion that a high percentage of children with diabetic ketoacidosis have some element of cerebral injury or dysfunction at the time of presentation even before the initiation of treatment.…”

Section: Discussionsupporting

confidence: 41%

Serum Levels of Neuron-Specific Enolase in Children With Diabetic Ketoacidosis

et al. 2017

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Neuron-specific enolase is a sensitive marker of neuronal damage in various neurologic disorders. This study aimed to measure serum neuron-specific enolase levels at different time points and severities of diabetic ketoacidosis. This study included 90 children (age 9.2 ± 3.4 years) with diabetic ketoacidosis. Neuron-specific enolase was measured at 3 time points (baseline and after 12 and 24 hours of starting treatment). Among patients, 74.4% had diagnosis of new diabetes, 60% had Glasgow Coma Scale score <15, and 75.6% had moderate/severe diabetic ketoacidosis. Compared with controls (n = 30), children with diabetic ketoacidosis had higher neuron-specific enolase levels at the 3 time points ( P = .0001). In multiple regression analysis, the factors associated with higher neuron-specific enolase levels were younger age, higher glucose, lower pH, and bicarbonate values. This study indicates that serum neuron-specific enolase is elevated in diabetic ketoacidosis and correlated with the severity of hyperglycemia, ketosis, and acidosis. This study indicates that diabetic ketoacidosis may cause neuronal injury from which the patients recovered partially but not completely.

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Section: Discussionsupporting

confidence: 41%

Serum Levels of Neuron-Specific Enolase in Children With Diabetic Ketoacidosis

et al. 2017

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“…A study conducted in the province of Sindh, showed higher rate of complication in subjects with T1D. Authors have reported that every fourth person with T1D is suffering from any one of the chronic complication while 2% subjects with T1D had diabetic ketoacidosis (DKA) and 21% had history of DKA[9]. Similar trend was noted in smaller scale studies from this region[8,10].…”

Section: Introductionmentioning

confidence: 57%

“…Polyphagia, polyuria, polydipsia, weight loss history, and DKA history which are confirmed if previous records are present were recorded. In suspected cases of DKA, blood pH, HCO3 was done[9].…”

Section: Methodsmentioning

confidence: 99%

Optimized health care for subjects with type 1 diabetes in a resource constraint society: A three-year follow-up study from Pakistan

Ahmedani

Fawwad

Shaheen

et al. 2019

WJD

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BACKGROUNDInadequate health infrastructure and poverty especially in rural areas are the main hindrance in the optimal management of subjects with type 1 diabetes (T1D) in Pakistan.AIMTo observe effectiveness of diabetes care through development of model clinics for subjects with T1D in the province of Sindh Pakistan.METHODSA welfare project with name of “Insulin My Life”, was started in province of Sindh, Pakistan. This was collaborative work of Baqai Institute of Diabetology and Endocrinology, World Diabetes Foundation and Baqai Medical University between February 2010 to February 2013. Under this project thirty-four T1D clinics were established. Electronic database was designed for demographic, biochemical, anthropometric and medical examination. Monthly consultation was part of the standardized diabetes care. All the recruited subjects with T1D were provided free insulins and related materials.RESULTSOut of 1428 subjects, 795 (55.7%) were males and 633 (44.3%) were females. Subjects were categorized into ≤ 5 years of age 103 (7.2%), between 6-12 years 323 (22.6%), between 13–18 years 428 (29.7%) and ≥ 19 years of age 574 (40.2%) groups. Glycemic control as assessed by HbA1c was significantly improved (P < 0.0001) at three years follow up as compared to baseline in all age groups. Decreasing trends of mean self-monitoring blood glucose were observed at different meal timings in all age groups. No significant change was found in the frequency of neuropathy, nephropathy and retinopathy during the study period (P > 0.05).CONCLUSIONThis study gives us long-term longitudinal data of people with T1D in a resource constraint society. With provision of standardized and comprehensive care significant improvement in glycemic control without any change in the frequency of microvascular complications was observed over 3 years.

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“…Type 1 diabetes mellitus (T1DM) is one of the most common immune-mediated childhood diseases that can lead to early morbidities and mortalities [1]. It can occur at any age, but the peak of its incidence is noted below 18 and over 60 years of age [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Type 1 Diabetes Mellitus And Its Complications In Children Aged ≤20 Years From Punjab, Pakistan

Ahmed,

Roohi,

Ahmed

et al. 2024

Russ Open Med J

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Background — Type 1 diabetes mellitus causes serious disease complication in children. Objectives- The main objective of this study was to assess the frequency and severity of diabetic complication in children ≤ 20 years of age from Punjab, Pakistan. Methods — The data of diabetic patients and their blood samples were collected from the diabetic registries at three districts of Punjab, Pakistan. Fasting plasma glucose, random plasma glucose, HbA1c, and GAD-65 autoantibodies were measured in sampled blood serum. The data on other clinical symptoms at the onset of disease were recorded as well. Results — Out of 310 patients, 54.2% were male, and their mean age at the onset of disease was 13.22 years. Among all patients, according to clinical indicators, high severity of the disease and serious complications were revealed. Conclusions — The diabetic complications were severe in all patients from three districts of Punjab, Pakistan, at and below the age of 20 years.

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Trends of type 1 diabetes in Karachi, Pakistan

Abstract: This is the first study in Pakistan to assess the mode of presentation and prevalence of acute and chronic complications in T1DM. Larger scale prospective studies are needed to have more detailed informative data.

Cited by 8 publications

References 20 publications

Serum Levels of Neuron-Specific Enolase in Children With Diabetic Ketoacidosis

Serum Levels of Neuron-Specific Enolase in Children With Diabetic Ketoacidosis

Optimized health care for subjects with type 1 diabetes in a resource constraint society: A three-year follow-up study from Pakistan

Type 1 Diabetes Mellitus And Its Complications In Children Aged ≤20 Years From Punjab, Pakistan

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