NEWLY DIAGNOSED T1DM PATIENTS

A DESCRIPTIVE STUDY IN A CHILDREN’S HOSPITAL

Abstract

INTRODUCTION
Type-1-diabetes mellitus (T1DM) is the most commonly diagnosed type of DM in children and adolescents. Typically, the presentation of T1DM is either as classic new onset DM, silent DM, or diabetic ketoacidosis (DKA). We aim to describe the epidemiological profile, clinical presentation, and factors related to delayed diagnosis in our patients.

METHODOLOGY
We retrospectively evaluated all newly diagnosed T1DM patients that presented to our centre from January 2015 till May 2021. Diagnosis of T1DM is based on clinical phenotype, with or without antibody confirmation

RESULTS
A total of 22 patients were identified. From 2015 to 2020, with an average of 2.3 cases per year. In the first 5 months of 2021 alone, there is a total of 8 new cases. Majority of the patients fell in the 5-9 years age group and were of Kadazan-Dusun ethnicity. One patient was noted to be obese at time of diagnosis. 77.3 % of all the cases presented with DKA and of this, 64.7% were severe DKA. Median length of hospital stay was 7 days for children with DKA versus 3 days for those without DKA. 76% of children with DKA required ICU care. 50% of all patients had the classical triad of symptoms of polyuria, polydipsia and weight loss. Other symptoms included visual blurring, penile discharge, dysuria and light-headedness. One patient had concurrent nephritis and one had COVID-19 co-infection. One death was reported with case fatality ratio at 4.5%. Four patients were misdiagnosed at presentation. Among the cited reasons for delayed diagnosis was failure to recognise symptoms of T1DM.

CONCLUSION
Majority of the newly diagnosed T1DM presented with DKA with high proportion of severe disease. More health awareness is needed in our community.