BSPED2023 Poster Presentations Diabetes 4 (12 abstracts)
Regional audit on presentation in diabetic ketoacidosis(DKA) at the manifestation of type1 diabetes in children and young people within Yorkshire and Humber region (YH)
Astha Soni 1 , Shaimaa Sahmoud 2,3 , Geraldine Lennon 4 , Sunil Bhimsaria 5 , Lovlin Joseph 6 , Anuja Natarajan 7 , Shaun Gorman 8 , Stephanie How-Yaw 9 , Nasar Alaber 10 , Verghese Matthew 11 , Fiona Campbell 12 , Victoria Hemming 13 , Imran Bashir 14 , Elizabeth Baker 15 , Nandita Danda 16 , Madhavi Madhusudhana 17 , Wendy Watts 18 , Emma Savage 12 & Sanjay Gupta 11
1Sheffield Childrens Hospital NHS Foundation Trust, Sheffield, UK; 2Yorkshire and Humber Deanery, Hull, UK; 3Suez Canal University, Egypt, Egypt; 4Airedale NHS Foundation Trust, Airedale, UK; 5Barnsley Hospital NHS Foundation Trust, Barnsley, UK; 6Doncaster and Bassetlaw NHS Hospitals Foundation Trust, Bassetlaw, UK; 7Doncaster and Bassetlaw NHS Hospitals Foundation Trust, Doncaster, UK; 8Beadford Teaching Hospitals NHS Foundation Trust, Bradford, UK; 9Calderdale and Huddersfield NHS Foundation Trust, Calderdale, UK; 10Harrogate and Distrcit NHS Foundation Trust, Harrogate, UK; 11Hull University Teaching Hospitals NHS Trust, Hull, UK; 12Leeds Teaching Hospitals NHS Trust, Leeds, UK; 13Mid Yorkshire Hospitals NHS Trust, Dewsbury, UK; 14The Rotherham NHS Foundation Trust, Rotherham, UK; 15York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK; 16North Linconshire and Goole NHS Foundation Trust, Grimbsby, UK; 17North Linconshire and Goole NHS Foundation Trust, Scunthorpe, UK; 18York and Scarborough Teaching Hospitals NHS Foundation Trust, Scarborough, UK
The incidence of children presenting with DKA at diagnosis has been on the rise worldwide1. 25.8% of newly diagnosed children had DKA at diagnosis according to the NPDA report (2020/21). 34% of newly diagnosed children in the Yorkshire and Humber(Y&H) region presented in DKA2. Delayed presentation due to lack of awareness is a likely cause for that.
Aim: To review the presentations of DKA at diagnosis in the YH region. Methods: Prospective regional audit included 15 diabetes units in YH area. The audit was coordinated by the YH diabetes network. Prospective data was collected over one year (January 2022–December 2022). Results: There were 334 newly diagnosed type I diabetes children, 137 (41%) presented with DKA, 54 (16.7%) presented with severe DKA. 107 (78%) of children who presented in DKA contacted health care professionals within the last 2 weeks. 92/107 (85.9%) were diagnosed at first contact. The most contacted health care professional was GP by 75 (70.1%) families. The mean duration of symptoms 17(8.9–45) days. The most common symptoms were polyurea and polydipsia in 127 (92.7%), followed by weight loss and fatigue in almost 75% of children. Only 19 (13.9%) of families suspected diabetes before contacting HCP and 20 (14.6%) of them knew family members diagnosed with diabetes.
| Gender | |
| Boys | 76 (55.5%) |
| Girls | 61 (44.5%) |
| Mean age at diagnosis (Y) | 9+1.88 |
| Ethnicity | 108 (85%) |
| White British / any other white | |
| Asian | 10 (7.9%) |
| Black, Caribbean, or African | 2 (1.6%) |
| Mixed ethnic group | 3 (2.4%) |
| Others | 4 (3.1%) |
| Has siblings n (%) | 100 (73%) |
Conclusion: Many children presented with DKA at diagnosis despite longer duration of diabetes symptoms and not all of them were diagnosed at first contact with HCP. This data highlights the importance of raising awareness about type 1 diabetes within communities and primary care.Table 1 Demographics
References: 1. Segerer H, Wurm M, Grimsmann JM, Karges B, Neu A, Sindichakis M, Warncke K, Dost A, Holl RW. Diabetic Ketoacidosis at Manifestation of Type 1 Diabetes in Childhood and Adolescence—Incidence and Risk Factors. Dtsch Arztebl Int. 2021 Jun 4;118(22):367–372. doi: 10.3238/arztebl.m2021.0133.2. https://www.rcpch.ac.uk/sites/default/files/2023-03/npda_2021-22_report_on_ care_and_outcomes.pdf.
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