Arch Dis Child. Published Online First: 18 June 2008. doi:10.1136/adc.2007.133405
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Delayed diagnosis in Type 1 diabetes mellitus
1 Birmingham Children's Hospital, United Kingdom
* To whom correspondence should be addressed. E-mail: jeremy.kirk{at}bch.nhs.uk.
Accepted 2 June 2008
Abstract
Children with suspected type 1 diabetes mellitus (T1DM) should have same day referral to a paediatric diabetes team.
99 children (54 male, median age 10.5 years (range 0.9 -15.9)) were diagnosed with T1DM at our hospital between Jan 2004 and June 2007. 27(27.2%) presented in diabetic ketoacidosis (DKA). 37(37.3%) required hospital admission; the rest had ambulatory management.
In 21(21.2%) diagnosis was delayed > 24 hours (median 3.0 days (range 1 - 14)), due to: missed diagnosis at local hospital (4) or by GP (7); arranging fasting blood glucose (9); outpatient appointment requested via fax (1). Children with delayed diagnosis presented more frequently in DKA (52.3% vs. 20.5%, p <0.01), with a higher mean presenting HbA1c (12.3% vs. 10.9%, p <0.05).
There was no difference in age and sex between the delayed diagnosis and immediate referral groups. Healthcare providers need to be aware of the importance of immediate referral of newly diagnosed T1DM in children.
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