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Clinical features, biomarkers and diabetic ketoacidosis at diagnosis of type 1 diabetes among children and adolescents in Sana’a, Yemen
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Clinical features, biomarkers and diabetic ketoacidosis at diagnosis of type 1 diabetes among children and adolescents in Sana’a, Yemen
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Journal Article
Clinical features, biomarkers and diabetic ketoacidosis at diagnosis of type 1 diabetes among children and adolescents in Sana’a, Yemen
2024
Overview
IntroductionThere is little published information on type 1 diabetes (T1D) in children in Yemen. We aimed to identify the clinical characteristics, biomarkers and diabetic ketoacidosis (DKA) at diagnosis of T1D among children and adolescents in a diabetes centre in Sana’a, Yemen.MethodsA total of 485 children and adolescents aged ≤18 years diagnosed with T1D during the period 2010–2020 were included in the study. The variables investigated were demographic and clinical characteristics, biomarkers, subtypes of T1D, and the risk factors for severe DKA at diagnosis.ResultsAt diagnosis, children aged <10 years compared with those aged ≥10 years had higher mean plasma glucose (p<0.001) and mean HbA1c (p=0.026), and lower mean C-peptide (pmol/L) (p=0.019), and a higher frequency of DKA at diagnosis than older children (p<0.001). A majority of the study population (383, 79%) presented in DKA . Children aged <10 years presenting with DKA had significantly longer median appraisal interval (p=0.009) and median total diagnosis interval (p=0.025), and significantly lower mean C-peptide (p=0.001) as compared with their peers without DKA. The prevalence of autoantibody-negative ‘idiopathic’ T1D was 36 (32%) of the total number tested for autoantibody and familial T1D 61 (12.6%) of all the study population.ConclusionIn Yemen children aged <10 years with new-onset T1D frequently faced the challenge of a delay in diagnosis and treatment initiation, with severe hyperglycaemia and a higher risk of DKA at diagnosis.
Publisher
BMJ Publishing Group Ltd,BMJ Publishing Group LTD,BMJ Publishing Group
Subject
/ Age
/ Child
/ Diabetes
/ Diabetes Mellitus, Type 1 - blood
/ Diabetes Mellitus, Type 1 - diagnosis
/ Diabetes Mellitus, Type 1 - epidemiology
/ Diabetic Ketoacidosis - blood
/ Diabetic Ketoacidosis - diagnosis
/ Diabetic Ketoacidosis - epidemiology
/ Female
/ Glucose
/ Glycated Hemoglobin - analysis
/ Glycated Hemoglobin - metabolism
/ Humans
/ Insulin
/ Low and Middle Income Countries
/ Male
/ Peptides
/ Puberty
/ Urine
