Clinical Profile of Type 1 Diabetes Mellitus in Children less than 18 years age, in a Tertiary Care Centre, Bhilai, Chhatisgarh, India: A Cross-sectional Study

Introduction: Type 1 Diabetes Mellitus (T1DM) is a very common paediatric endocrine disorder and is increasing each year, particularly in younger children. The T1DM presents as Diabetic Ketoacidosis (DKA) in a significant number of patients. Race, ethnicity, age, and parent education plays an important role in the glycaemic control of the disease. Conflicting data are available about the age of onset, gender predominance, family history, and growth in various international and national studies.

Aim: To study the clinical presentation of T1DM in children aged less than 18 years.

Materials and Methods: The observational cross-sectional study was conducted from April 2011 to March 2013 at Jawaharlal Nehru Hospital and Research Centre, Bhilai, Chhattisgarh, India. Total 46 patients with T1DM, aged less than 18 years were included in the study. Socio-demographic data, clinical presentation, age, insulin dose, anthropometry, and laboratory investigations were collected using semi-structured performa. Statistical analysis was done by using Statistical Package for Social Sciences version 26.0.

Result: Total 46 patients with T1DM attended the hospital with 24 (52.8%) boys and 22 (47.2%) girls. A 28 (60.8%) of patients presented with DKA. 16 (34.8%) of patients were less than 5 years of age. The youngest patient was of 2.5 years of age. In the present study, stunting was noted in 12 (26.08%) patients. Polyuria (85%) was the most common presenting complaint in newly diagnosed diabetes patients and pain in the abdomen (50%), breathlessness (46.8%) were the most common presenting complaint in established diabetics. Patients with poor control (HbA1c- >8.5%) had significantly higher mean age (12.3±4.01) than the group with good control (HbA1c< 8.5%) has mean age (8.5±3.54 years). Availability of medical facilities, higher socio-economic status, and parents’ education was found to be significantly associated with good glycaemic control.

Conclusion: Polyuria was the most common symptom in newly diagnosed diabetics. Higher age was a significant risk factor for poor control of diabetes. DKA may present with respiratory distress in a significant number of patients.