Diabetes Mellitus in Childhood and Adolescence:
Analysis of Clinical Data of Patients Seen in a Nigerian Teaching Hospital
Abstract
Background: The clinical profile of African children and adolescents with diabetes mellitus is known to differ from that of their non-African counterparts.
Objective: To present an analysis of the clinical data of children and adolescents with diabetes mellitus seen in a Nigerian teaching hospital between 2005 and 2011 and highlight the management challenges encountered.
Methods: In this retrospective study, the case notes of all children and adolescents with diabetes Mellitus seen in the Paediatric Endocrine-Metabolic Clinic and of those admitted into the paediatric wards of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria were audited. Information extracted included age, sex, presenting features, educational attainment of parents, occupation of parents, insulin management, complications and outcome of patients. The clinic attendance registers of the Department of Child Health, UBTH was examined to obtain information on total number of patients seen by all the units in the department between 2005 and 2011.
Results: Seventeen (0.2%)of the 8,350 casesseenduringtheperiodunderreviewhaddiabetesmellitus, representing 2 per 1000 cases with a male-to-female ratio of 1: 1.8. The mean age at presentation was 212.8 ±2.9 years for both sexes combined. The mean body mass index (BMI) was 18.6±2.5 kg/m . Diabetic ketoacidosis (DKA) was the initial presentation in 9 (52.9%) of cases. The mean duration of symptoms before presentation was 2.7±1.8 months. Only 10(58.8%) of the 17 patients had glucose meter for self- monitoring of blood glucose at home. Of the 17 patients, 6 (35.3%) had documented evidence of hypoglycaemia. During the period under review, 4 (23.5%) were re-admitted; of which 3 were for DKA. Seven (41.2%) of the parents had difficulty procuring insulin on a regular basis.
Conclusion: In the present study,the unique clinical features observed among children with diabetes mellitus were late presentation, high number of cases presenting with DKA and requiring re-admission. The major management challenges included difficulty procuring insulin on a regular basis and inability to acquire a glucose meter with test strips for self-monitoring of blood glucose at home.
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