Background: Type 1 Diabetes (T1DM) is one of the most common paediatric endocrine disorders in India, but diagnosis is often delayed. Moreover, systematized data about symptoms, presentation, management and follow-up of T1DM in India is lacking. Absence of such data makes formulation of uniform region and nationwide protocols for diagnosis, management and follow-up of T1DM patients difficult.
Objective and hypotheses: To generate data about presentation and management of T1DM, to identify risk factors for delayed diagnosis of T1DM, identify other chronic conditions associated with T1DM and to focus on prevailing socio-economic factors which could have an impact on T1DM management.
Method: A retrospective analysis of all children attending the pediatric endocrine unit at a tertiary level hospital from April 2014 to March 2016. Detailed questionnaire was administered to the patients and their parents and anthropometric measurements obtained from the patients along with physical examination.
Results: 221 children were included, of whom 118 were girls and 103 were boys. Mean±S.D. age of diagnosis was 9.2±4.3 years. The commonest symptom was polyuria (95.7%), followed by weight loss (80.3%). Commonest mode of presentation was with osmotic symptoms (52.5%), followed by diabetic ketoacidosis (45.5%). Winter was the commonest season of diagnosis (49.3%). The commonest associated autoimmune disorder was hypothyroidism (8.1%). The commonest insulin regimen was split mix regimen using regular insulin thrice a day and intermediate insulin twice a day, before meals (48.5%). There were no differences between sexes for any of these findings.
Conclusion: Winter was the commonest season for diagnosis. Diabetic ketoacidosis is no longer the commonest mode of presentation. Commonest symptom is polyuria. Hypothyroidism was the commonest associated disorder and there did not seem to be any gender bias in presentation.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology