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Opportunities for earlier diagnosis of type 1 diabetes in children: A case-control study using routinely collected

Joseph Jonathan Lee1, Matthew James Thompson2, Juliet Alexandra Usher-Smith3

  • 1Nuffield Department of Primary Care Health Sciences, Radcliffe Primary Care, Radcliffe Observatory Quarter, Woodstock Rd, Oxford OX2 6GG, UK.

Primary Care Diabetes
|March 18, 2018
PubMed

Insights

Earlier diagnosis of type 1 diabetes mellitus (T1DM) in children is possible. Primary care visits in the week before diagnosis increased significantly, suggesting missed opportunities for earlier T1DM detection.

Area of Science:

  • Pediatric Endocrinology
  • Primary Care Medicine
  • Diabetes Epidemiology

Background:

  • Type 1 diabetes mellitus (T1DM) diagnosis delays are linked to diabetic ketoacidosis in children.
  • Earlier T1DM diagnosis in primary care settings is a critical unmet need.

Purpose of the Study:

  • To quantify opportunities for earlier diagnosis of T1DM in children within UK primary care.
  • To analyze primary care consultation patterns preceding T1DM diagnosis.

Main Methods:

  • A matched case-control study involving children aged 0-16 years presenting to UK primary care.
  • Analysis of routinely collected primary care data and National Institute for Health and Care Excellence (NICE) warning signs within 13 weeks of diagnosis.

Main Results:

  • In the week before diagnosis, T1DM cases had more medical record entries (34.5% vs 13.6%) and higher face-to-face consultation rates (mean 0.32 vs 0.11) compared to controls.
  • Medical record entries in the preceding week were also higher in cases (17.2% vs 12.3%), though face-to-face consultations did not differ significantly.

Conclusions:

  • Opportunities exist to reduce T1DM diagnosis time for up to one-third of children by up to two weeks.
  • Improving primary care access and public awareness of T1DM symptoms can maximize diagnostic opportunities.
Abstract

Keywords:
ChildrenDiagnosisPrimary careType 1 diabetes mellitus

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