Can primary care physicians recognize type 1 diabetes in children on time?

Abstract

Although the diagnostic criteria for diabetes in children and adolescents should be widely known to all healthcare professionals, many cases of type 1 diabetes (DM1) are still not recognized in time. The aim of this study was to compare the experiences with the diagnosis of DM1 of young doctors during training and specialists working as primary health care physicians in Poland. 50 specialists in paediatrics or family medicine (average professional experience of 14.6 years) and 50 doctors, and those without specialization (up to 4 years after graduating from medical studies, average professional experience of 1.4 years) participated in the survey. The questionnaires were conducted from November 2019 to November 2020. Most of the study participants correctly answered the questions about the diagnostic criteria of diabetes and its management at the moment of diagnosis, except for the question regarding diagnostic criteria for diabetes in oral glucose tolerance test. The correct answers varied from 96% to 72% among medical specialists and physicians during the training, respectively. What is interesting is the relatively small number of diagnosed cases of DM1 during the entire professional career of specialists (0-12 cases), compared to the doctors without specialization (0-5 cases). Medical specialists declared more frequently the use of a glucometer in their daily practice (mean 6 vs. 1, p < 0.05), but after taking into account the years of experience, the difference was insignificant. It is important to educate primary care physicians, despite their professional experience. Practical education of physicians is also necessary.