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Type 1 diabetes mellitus in pediatric age group: A rising endemic
Rachna Pasi1, Kumar Satish Ravi2
1Department of Pediatrics, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India.
Insights
Type 1 Diabetes Mellitus (T1DM) is rising in children globally. Early detection and management are crucial, as high HbA1c levels at diagnosis correlate with increased complication risks.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Public Health
Background:
- Type 1 Diabetes Mellitus (T1DM) is the predominant endocrinological condition in pediatric populations worldwide.
- Increasing global incidence suggests a complex interplay of genetic predisposition and environmental triggers in T1DM pathogenesis.
- T1DM results from autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency.
Purpose of the Study:
- To conduct a literature review on Type 1 Diabetes Mellitus in children.
- To determine the point prevalence of T1DM and analyze clinical correlates in pediatric patients at a tertiary care hospital.
- To identify risk factors associated with T1DM complications in children.
Main Methods:
- Comprehensive literature review on pediatric T1DM.
- Clinical audit of T1DM cases over a 2.5-year period (April 2015-September 2017) at AIIMS Rishikesh.
- Analysis of presenting clinical features, prevalence, and HbA1c levels.
Main Results:
- The point prevalence of Type 1 Diabetes Mellitus was found to be 2.88%.
- Common presenting symptoms included polyuria (56.5%), polydipsia (34.8%), polyphagia (21.7%), and weight loss (39.1%).
- Diabetic ketoacidosis occurred in 26.1% of patients, and 94.4% had elevated HbA1c levels at presentation.
Conclusions:
- Children with T1DM often present with significant hyperglycemia (high HbA1c) and prolonged symptoms.
- Higher HbA1c levels and longer symptom duration at diagnosis are associated with an increased risk of developing diabetes-related complications.
- Timely diagnosis and intervention are critical for improving outcomes in pediatric T1DM.
Abstract:
Type 1 Diabetes Mellitus is the most common endocrinological abnormality found in children. The incidence of T1DM has steadily increased in nearly all parts of the world. Both genetic susceptibility and environmental factors contribute to the pathogenesis. It is caused due to either decreased or absent insulin production in the body due to multiple etiologies. We have done a literature review of type 1 DM in children and a clinical audit of point prevalence of type 1 DM cases & its clinical correlates of patients presenting at the tertiary level hospital, AIIMS Rishikesh, over two years six months period (April 2015 to September 2017). We found the prevalence of diabetes mellitus (Type 1) is 2.88%. Among clinical features at presentation, 56.5% presented with polyuria, 34.8% with polydipsia, 21.7% with polyphagia, 39.1% with weight loss. 26.1% of patients had diabetic ketoacidosis at presentation. The majority of children have deranged HbA1C levels (94.4%). It is concluded that children presented with higher HbA1c levels at onset and higher duration of symptoms are at greater risk for the development of complications.
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