Etiology, risk factors, clinical features, and pitfalls in the management of newly diagnosed diabetic children and adolescents

Abstract

Objective The aim of this study was to identify the etiology, risk factors, and the most common clinical features of newly diagnosed diabetes in children and adolescents, in addition to the factors related to delayed diagnosis or mismanagement in these children.Materials and methods Ninety-nine children and adolescents aged from one month to 13 years with newly diagnosed type 1 diabetes (T1DM) were recruited from the inpatient department of the Diabetic, Endocrine, and Metabolic Pediatric Unit (DEMPU), New Children Hospital, Cairo University.Results Classic symptoms (polyuria and polydipsia, and weight loss) were the most common symptoms (the first two symptoms in 95.9 and the last one in 90.7%) preceding the diagnosis, and diabetic ketoacidosis was present in 51.5% of cases. Delayed and missed diagnosis was recorded in 49.5% of patients, with no significant relation with age, district of accommodation, or family history of diabetes. Cow's milk feeding was more frequent, being recorded in 75.2% vs. 19.6% with exclusive breast feeding, and positive family history of diabetes was recorded in 77.3%. Severity at presentation showed no significant relation with age, type of feeding, family history of diabetes, or C-peptide level.Conclusion Increased public awareness of early symptoms of diabetes is needed to reduce the frequency and severity of ketoacidosis. In addition, greater medical alertness to the possibility of T1DM in a young child should be stressed. Breastfeeding and avoidance of early cow milk introduction should be encouraged to decrease the risk for T1DM during infancy with its early complications and morbidity.