The morbidity pattern among children and adolescents with type 1 diabetes attending diabetic clinic in a tertiary care centre

Background: Type 1 diabetes (T1D) is a chronic disease which needs prompt diagnosis, frequent monitoring and appropriate therapy to prevent complications. Objectives: To study the morbidity pattern among children with T1D. Method: For this prospective observational study, 234 children and adolescents aged 1-17 years with T1D, attending the diabetic clinic in a tertiary care centre, were recruited and followed up quarterly for 1 year. Anthropometric measurements and glycaemic status by mean of HbA1c were assessed quarterly, along with annual target organ assessments and documentation of T1D related events during each period. The health outcome measures studied included acute and chronic complications of T1D like hypoglycaemia, diabetic ketoacidosis (DKA), growth faltering, micro-vascular and treatment related complications. Results: Of the participants, 42.7% were in the 6–10-year age group and 74.4% had duration of illness 1-5 years. Acute complications, like hypoglycaemia, were experienced by 52.5% (severe hypoglycaemia by 4.7%) and DKA by 9.4% subjects. Height faltering was observed in 56.1% of the subjects and had a significant association with poor glycaemic control. Among chronic complications, 3.4% had microalbuminuria, 0.9% had nephropathy, 0.9% had retinopathy and 0.9% had cataract. Lipodystrophy was observed in 15.3%. Comorbidities observed included hypothyroidism in 10.3% and coeliac disease in 0.9%. Conclusions: At the time of diagnosis 56.8% had DKA. The major morbidities observed were hypoglycaemia and height faltering. Height faltering was significantly associated with poor glycaemic control. Micro-vascular complications were even detected in children <11years and duration of T1D <2 years.