Difficulties or mistakes in diagnosing type 1 diabetes in children?—demographic factors influencing delayed diagnosis
Article first published online: 28 MAY 2009
© 2009 John Wiley & Sons A/S
Volume 10, Issue 8, pages 542–549, December 2009
How to Cite
Pawłowicz, M., Birkholz, D., Niedźwiecki, M. and Balcerska, A. (2009), Difficulties or mistakes in diagnosing type 1 diabetes in children?—demographic factors influencing delayed diagnosis. Pediatric Diabetes, 10: 542–549. doi: 10.1111/j.1399-5448.2009.00516.x
- Issue published online: 23 NOV 2009
- Article first published online: 28 MAY 2009
- Submitted 04 August 2008. Accepted for publication 23 February 2009
- diabetic ketoacidosis;
- diagnostic errors;
- population characteristics
Background: Diabetic ketoacidosis (DKA) development in children with new-onset type 1 diabetes (T1DM) is often the main consequence of delayed diagnosis.
The aim of the study was to estimate the frequency of difficulties in T1DM diagnosis and to investigate if and how the demographic factors (gender, patient's age at presentation, family history of T1DM, level of maternal education, place of residence, and health service unit the patient called at) have any influence on diagnostic delays.
Subjects and methods: Retrospective analysis of 474 children (243 boys—51.27% and 231 girls −48.73%) with new-onset T1DM aged below 17 yr and living in the Pomeranian region of Poland was carried out. The delay in diagnosis was recognized if the patient was not diagnosed on the first visit because of omission, wrong interpretation of main diabetic symptoms, exclusive treatment of additional signs, or concomitant diseases.
Results: Difficulties in diagnosing T1DM were found in 67 cases (14.13%) and they are the main cause of DKA development in these children (p = 0.00). Among the examined demographic factors, mainly the patient's age at presentation has a significant influence on diagnostic delays (p = 0.01), especially in children below 2 yr (p = 0.00). Most frequently family doctors were responsible for wrong preliminary diagnosis.
Conclusions: Difficulties in diagnosing T1DM are a significant cause of DKA development in children with new-onset disease. Patient's age at presentation is the main risk factor of delayed diagnosis, especially in children below 2 yr. The increase in awareness among pediatricians concerning the possibility of T1DM development in children is needed.