Related Experiment Video
Updated: Apr 16, 2026
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
The pathway to diagnosis of type 1 diabetes in children: a questionnaire study
Juliet A Usher-Smith1, Matthew J Thompson2, Hannah Zhu3
1The Primary Care Unit, University of Cambridge, Cambridge, UK.
Insights
Diagnosing type 1 diabetes (T1D) in children often involves delays, with many presenting in diabetic ketoacidosis. Improving parental awareness of T1D symptoms and addressing healthcare access barriers are crucial for earlier diagnosis.
Area of Science:
- Pediatric Endocrinology
- Diabetes Mellitus Research
- Public Health
Background:
- Type 1 diabetes (T1D) diagnosis in children can be delayed, impacting outcomes.
- Early recognition of T1D symptoms is vital for timely intervention.
Purpose of the Study:
- To investigate the diagnostic pathway for type 1 diabetes in pediatric patients.
- Identify factors contributing to delays in T1D diagnosis.
Main Methods:
- Parental questionnaires were administered to families of children diagnosed with T1D within three months.
- Data collected from 11 hospitals in the East of England.
- Included children aged 1 month to 16 years.
Main Results:
- 54% of invited families returned questionnaires; 39.8% of children presented with diabetic ketoacidosis.
- Common symptoms included polydipsia, polyuria, tiredness, nocturia, and weight loss.
- Median time to diagnosis was 25 days, with delays often occurring before seeking medical advice; 20% were not diagnosed on first primary care encounter.
Conclusions:
- Children exhibit typical T1D symptoms, yet diagnostic delays persist.
- Interventions should focus on enhancing parental symptom recognition and addressing perceived healthcare access barriers.
- Parental suspicion of T1D increased the likelihood of diagnosis at the first consultation.
Objective:
To explore the pathway to diagnosis of type 1 diabetes (T1D) in children.
Design:
Questionnaire completed by parents.
Participants:
Parents of children aged 1 month to 16 years diagnosed with T1D within the previous 3 months.
Setting:
Children and parents from 11 hospitals within the East of England.
Results:
88/164 (54%) invited families returned the questionnaire. Children had mean±SD age of 9.41±4.5 years. 35 (39.8%) presented with diabetic ketoacidosis at diagnosis. The most common symptoms were polydipsia (97.7%), polyuria (83.9%), tiredness (75.9%), nocturia (73.6%) and weight loss (64.4%) and all children presented with at least one of those symptoms. The time from symptom onset to diagnosis ranged from 2 to 315 days (median 25 days). Most of this was the appraisal interval from symptom onset until perceiving the need to seek medical advice. Access to healthcare was good but one in five children presenting to primary care were not diagnosed at first encounter, most commonly due to waiting for fasting blood tests or alternative diagnoses. Children diagnosed at first consultation had a shorter duration of symptoms (p=0.022) and children whose parents suspected the diagnosis were 1.3 times more likely (relative risk (RR) 1.3, 95% CI 1.02 to 1.67) to be diagnosed at first consultation.
Conclusions:
Children present with the known symptoms of T1D but there is considerable scope to improve the diagnostic pathway. Future interventions targeted at parents need to address the tendency of parents to find alternative explanations for symptoms and the perceived barriers to access, in addition to symptom awareness.
Related Concept Videos
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:22Diabetes Mellitus: Type 2 and Gestational
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:15Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
01:36Carbohydrate Metabolism
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...