ESPE Abstracts

Keywords: Retrospective descriptive study, diabetes mellitus type 1, diabetic ketoacidosis, NDS-UMC, Byblos, Lebanon, single-center experience.

Background: Type 1 diabetes mellitus (T1DM) increases worldwide especially in the Mediterranean region. Epidemiological studies about T1DM are made in many countries, but Lebanon lacks such data.

Objective: This is a descriptive study of demographic and clinical characteristics of 78 patients presented to the Pediatric Endocrine Unit of Notre Dame Des Secours University Medical Center (NDS-UMC), Byblos, Lebanon between January 2002 and March 2020, with type 1 diabetes mellitus (T1DM) for the first time. Only 60 patients passed the exclusion criteria. The data was collected from medical files.

Results: In this study, the female/male ratio was (1:1.07), mean age at presentation was 7.48 years old for both genders combined, with 2 peaks of age category including 5 to 9 (40%) and 10 to 14 (33.3%). They presented mostly during winter (31.7%), fall (26.7%), spring (25%) then summer (16.6%) and from urban areas (66.7%). We found 11.7% of patients with family history of T1DM. The mean length of hospitalization stay was approximately 6 days. Two patients were admitted to the pediatric intensive care unit and the rest of the children were managed in the pediatric unit. Symptoms at presentation were 96.7% polyuria/ polydipsia, 56.7% weight loss, 33.3% fatigue/weakness, 31.7% abdominal pain, 23.3% nausea/vomiting, 15%Kussmaul respiration and 3.3% coma. Approximately 71.7% of children presented with diabetic ketoacidosis (DKA), severe DKA (62.8%), moderated (30.2%) and mild (7%). The mean pH at diagnosis was 7.25 ± 0.16 (6.82 – 7.48), mean plasma glucose was 517.33 ± 164.01 (162 – 948) and mean HbA1C was 10.56 ± 1.85 (9.2 – 19.7) and mean serum bicarbonate was 12.47 ± 7.92 (2 – 27.8). Regarding antibodies related to T1DM, anti-GAD antibody (61.1%), anti ICA antibody (50%), anti IA2 antibody (4 2.9%) and anti-IAA antibodies (6.25%) of children. Only 21.4% of patients were tested positive for anti-transglutaminase antibodies.

Conclusion: A very high proportion of children presented with DKA and almost all of them had polyuria/ polydipsia. The average number of hospitalization days was very high compared to other countries. Anti-IAA antibody had a very low percentage of positivity and a relatively important percentage of patients tested positive for anti-transglutaminase antibody.