Clinical and laboratory characteristics of type 1 diabetes in children and adolescents: experience from a medical center
Ting, W-Hsin.; Huang, C-Yu.; Lo, F-Sung.; Hung, C-Mei.; Chan, C-Jung.; Li, H-Jung.; Lin, C-Hsu.; Lee, H-Chang.; Lee, Y-Jinn.
Acta Paediatrica Taiwanica 48(3): 119-124
2007
ISSN/ISBN: 1608-8115 PMID: 17912982 Document Number: 2819
Background: The incidence of type I diabetes (T1D) is increasing rapidly worldwide, predominantly in younger individuals. We developed a checklist of all symptoms of T1D reported in the literature and compared the completeness of the recording of symptoms at initial presentation before and after the checklist was adopted.Methods: We retrospectively reviewed the records of patients newly diagnosed with T1D from January 1, 1979 through September 30, 2006 to assess the presenting features and test the usefulness of a symptom checklist in evaluating the history on presentation. The checklist was incorporated into the records as of October 1,1994.Results: Of the 304 patients identified, 130 (43%) had checklists in the charts. There were 146 (48%) boys, 98 (32%) who were diagnosed under the age of 6 years, and 198 (65%) presented with diabetic ketoacidosis (DKA). Records with a checklist noted diabetic symptoms that were subtle and easily ignored more often than records without the checklist. As compared with those diagnosed at an older age, patients diagnosed at <= 6 years were more likely to be male, have DKA and a shorter symptom duration, and report more episodes of preceding viral infection and dyspnea. Patients with DKA also had a shorter symptom duration.Conclusions: A diabetic symptom checklist was helpful in identifying clinical diabetic symptoms and signs which were otherwise easily ignored. Younger children were more likely to have a shorter symptom duration and a higher incidence of DKA.
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