A Ten-Year Review of the Pattern and Outcome of Childhood Diabetes in Two State Teaching Hospitals in South-West Nigeria

Abstract

Background

Childhood diabetes mellitus is a poorly researched topic in Nigeria. Its contribution to morbidity and mortality is vague. This study intends to provide additional information to the background data in Nigeria and hopefully proffers strategies to improving the outcome of this disease.

Methods

This is a retrospective descriptive study of all children managed for childhood diabetes mellitus at the Ekiti State University Teaching Hospital (EKSUTH) and LAUTECH Teaching Hospital (LTH), South West Nigeria, over a 10 year period. Relevant information was obtained from the case notes of all affected children. Data obtained were analysed with SPSS version 20 software.

Results

A total of 20 children were treated for diabetes mellitus (DM); there were 7 (35.0%) boys and 13 (65.0%) girls giving a M:F ratio of 1.0:1.9. Age range at presentation was 5 to 16 years and the mean age at presentation was 12.7 ± 2.89 years. Diabetic ketoacidosis (DKA) was the most common form of presentation in 13 (65.0%). Most [18 (90.0%)] of the patients had type 1 DM. Type 2 DM and glucocorticoid-induced diabetes mellitus were recorded in a case each, Eighteen (90%)patients had not been previously diagnosed by any form of screening prior to their presentation and admission in the hospital. Seven (35.0%) of the patient's care were affected by parental financial constraints. Five mortalities were recorded and one left against medical advice while the majority [14 (70.4%)] were discharged well and alive. The association between the greater numbers of deaths recorded in children with financial constraints was statistically significant (p < 0.05).

Conclusion

Type 1 DM remains the most predominant form of diabetes in children and most of the patients presented in DKA. The proportion of deaths in this study is unacceptably high. There is a need to proffer strategies for earlier detection and management of children with diabetes mellitus prior to the onset or development of DKA and there is a need to assist with the funding of the care of children with diabetes mellitus.

Keywords:

• pattern
• outcome
• childhood diabetes
• Nigeria

Compliance with Ethical Standards

• Disclosure of potential conflicts of interest; The authors declare that there is no conflict of interest in the conduct and write up of this manuscript. The study is not sponsored by any funding agency.

• Research involving Human Participants: There was no collection of blood samples and nothing was done that may negatively affect the patients during and after the conduct of the index study. Data about patients was kept confidential.

• Informed parental consent: The informed consent we obtained was informed parental consent and information about the patient was recorded and kept with their parent's consent.

• Ethical approval for the study was granted by the Ethics and Research Committee of the Ekiti State Teaching Hospital, Ado Ekiti, Ekiti State, and LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria. (Ethics Approval Numbers: EKSUTH/A67/2020/07/005 and LTH/EC/2020/08/469).

Disclosure

The authors report no conflicts of interest for this work.