Endocrine Abstracts

JOINT2175

Introduction: Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disorder leading to insulin deficiency. Lifelong use of insulin and optimal glycemic control (HbA1c < 7. 5%) is essential for preventing long-term complications and ensuring a good quality of life. Globally, variations in T1DM incidence, seasonal trends, clinical features, and glycemic control have been reported, largely influenced by ethnic, socioeconomic, and healthcare disparities. However, there is a paucity of comprehensive studies investigating these parameters among newly diagnosed T1DM patients in sub-Saharan Africa. Understanding these factors is crucial for identifying potential environmental triggers, optimizing treatment protocols, and improving patient care tailored to regional contexts.

Objective: To describe the seasonal trends, clinical characteristics, and glycemic control of T1DM patients at two private tertiary level hospitals in Nairobi, Kenya, from 2013 to 2023.

Methods: A retrospective descriptive study was conducted at Aga Khan University Hospital, and Gertrude’s Children Hospital Nairobi, involving 109 paediatric T1DM patients. Sample size was determined using Daniel’s formula. Clinical data, including age at diagnosis, diabetes duration, Diabetic ketoacidosis (DKA) at presentation, month of diagnosis, HbA1c levels, and insulin regimen, were analyzed using SPSS-25. Descriptive statistics summarized categorical and continuous variables.

Results: Among 109 patients analysed, 52. 3% were male, the mean age at diagnosis was 8. 67 years (SD = 4. 28), the peak age group being 5-12 years A seasonal trend was observed, with peak diagnosis during the cool dry season (June–September, 34. 3%) and short rainy season (October–December, 26%). DKA was observed in 55% of cases at the time of diagnosis. Basal-bolus therapy was the predominant insulin regimen (84. 4%). The mean HbA1c was 9. 49% (SD = 2. 3), with values ranging from 6. 4% to 15. 37% with mean diabetes duration of 6. 49 years (SD=3. 6). Private insurance (54. 3%) and self-pay (33. 3%) were the main payment methods.

Conclusion: This study identified a distinct seasonal pattern in paediatric T1DM diagnosis with peaks in the cool dry season (June–September) and short rainy season (October–December), suggesting potential environmental or infectious triggers. Notably, 52% of patients presented with DKA at diagnosis - significantly lower than the estimated 80% DKA prevalence in Africa. This indicates better awareness and healthcare access in our urban setting. However, despite earlier diagnosis and with relatively short disease duration (6. 4 years) - glycemic control remains poor (mean HbA1c 9. 49%) underscoring the need for enhanced diabetes management strategies, including use of diabetes technology such as continuous glucose monitoring and insulin pumps.