ESPE Abstracts (2016) 86 P-P2-299

Initial Presentation of Subjects with Type 1 Diabetes: A Change in Spectrum

Mathew John, Rejitha Jagesh, Asha Alex & Deepa Gopinath

Providence Endocrine and Diabetes Specialty Centre, Trivandrum/Kerala, India

Background: The classical presentation of type 1 diabetes mellitus is as diabetic ketoacidosis. As health awareness and access to healthcare improves, more subjects with type 1 diabetes are diagnosed early and present with less severe forms of hyperglycaemia. India accounts for most of the children with type 1 diabetes in South East Asia, but studies on the initial presentation is lacking from India.

Objective and hypotheses: The aim of the study was to analyse the initial presentation of subjects with type 1 diabetes attending outpatient department. Subjects with other forms of diabetes were excluded.

Method: The initial presentation of type 1 diabetes was classified arbitrarily into four types. Data was collected by referring to previous discharge summaries and patient histories from file. Type A: Classical diabetic ketoacidosis (DKA) requiring admission. Type B: Probable DKA. Type C: Severe hyperglycaemia requiring admission. Type D: Hyperglycaemia and/ketonuria managed as outpatient. Descriptive statistics were used and SOFA (Open Source) was used for statistics.

Results: There were 102 patients in the group. Mean age: 11 years (0.6–30 years, 48M, 54F). Majority of the patients were diagnosed in the 6–12 age group (35, 34.5%) followed by 13–18 years (27, 26.6%). 40% (39) of subjects did not require admission for management. In younger children (<6 years), all children were admitted at diagnosis (Type A: 25, Type B: 1). In the older group (>13 years), most patients were managed as outpatient (Type A: 1, Type D: 40). More subjects diagnosed after 2011 were managed as outpatient.

Conclusion: 40% of subjects with type 1 diabetes, did not require admission at presentation. Admission was more common among younger patients and those patients presenting before 2010.

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