Abstract
<i>Purpose</i>: Despite the high prevalence of diabetes mellitus (DM) reported among adult Uyo inhabitants in south-south Nigeria, no data exist on pediatric DM (PDM) to date. Hence, the current study aimed to evaluate pediatric subjects diagnosed with DM in Uyo, South-south Nigeria. <i>Methods</i>: This was a retrospective survey of incident/newly diagnosed PDM subjects diagnosed/managed over 15 years (2003-2018) at the University of Uyo Teaching Hospital (UUTH), South-south Nigeria. Patients’ demographic, clinical, and laboratory variables at PDM diagnosis were retrieved from medical records and analyzed using descriptive statistics. <i>Results</i>: 45,551 pediatric cases were managed during the studied period among them 9 PDM cases, all of type 1 DM, giving PDM prevalence of 0.20/1000. Age at diagnosis was 7.00±4.82 years (range 2-16) with a predominance of ≤5-year-olds (44.4%) and females (66.6%). Most (77.8%) presented via the pediatric outpatient clinic, during the rainy season (55.6%), were urban-dwellers (55.6%), of Ibibio ethnicity (55.6%), and lower socioeconomic status (44.4%). Three (33.3%) had DM family history, mostly in first-degree (n=2) relatives. Predominant symptoms were polyuria (100%), polydipsia (100%), weight loss (88.9%), and weakness (77.8%); polyuria being the most prolonged symptom. Three (33.3%) were underweight/stunted, and 2 (22.2%) were overweight. DKA complicated with AKI and dehydration-induced AKI was recorded in 2 respective cases. The default rate to follow-up was discouragingly high following diagnosis. <i>Conclusion</i>: The prevalence rate of PDM was relatively low, occurred mostly among the ≤5-year-olds, with a high rate of default to follow-up. These findings could serve as health policy targets by various stakeholders within the studied region.
Highlights
In Nigeria, a similar trend of worsening diabetes mellitus (DM) epidemiologic indices, especially of the type 1 DM (T1DM) variant, among the pediatric populations has been reported from different regions of American Journal of Pediatrics 2020; 6(3): 327-333 the country in few published data. [5,6,7,8,9,10,11,12,13] Uyo, the capital city of Akwa Ibom State in the Southern part of Nigeria, has been reported to have one of the highest adult DM prevalence rates in the country. [14, 15] no published data to date has been documented on DM among the pediatric populations in Uyo, South-south Nigeria
The prevalence of pediatric DM (PDM) among our studied population was 0.2/1000, which is in accord with the rate recorded in a similar study reported from Abakaliki (0.1/1000), south-eastern Nigeria, and Sokoto (0.33/1000), north-eastern Nigeria. [7, 9] The low prevalence is in keeping with the pattern of PDM reported in Sub-Sahara Africa. [23, 24] our reported prevalence was lower than the rates, which ranges between 1.4/1000 to 10.1/1000, recorded in most other Nigerian studies. [5, 6, 10,11,12,13] This may be adduced to the high patronage for informal healthcare services among the inhabitants within the studied region
26 Most of our studied population were ≤5 years at diagnosis which is at variance with most reports in the literature. [9,10,11,12,13, 24] These previous studies [913, 24] had documented a peak incidence of type 1 PDM within the 10-14 age-groups which coincides with the onset of puberty-induced hormonal impact on insulin sensitivity. [27, 28] The incidence of PDM in ≤5-year-olds is clinically significant because diabetes-related symptoms at this age are not usually classic which may further worsen symptoms and diabetic complications. [29]
Summary
In parallel to the increasing global burden of diabetes mellitus (DM) among the adult populations in recent times, the burden of the disease among the pediatric populations has posed a major public health concern. [1] recent epidemiologic evidence has documented an increasing burden of the metabolic disorder among the pediatric age-group with regards to the disease incidence, prevalence, morbidity, and overall mortality. [1,2,3]Historically, type 1 DM (T1DM) was adjudged as the predominant pediatric age-group DM type, recent findings indicate an increasing trend of type 2 DM (T2DM) among the pediatric populations. [3, 4] Etiologically, while TIDM undoubtedly has genetic attributes in association with some environmental triggers, the global overweight and obesity epidemic has been linked with the rising T2DM burden among the pediatric age-group populations. [1]In Nigeria, a similar trend of worsening DM epidemiologic indices, especially of the T1DM variant, among the pediatric populations has been reported from different regions of American Journal of Pediatrics 2020; 6(3): 327-333 the country in few published data. [5,6,7,8,9,10,11,12,13] Uyo, the capital city of Akwa Ibom State in the Southern part of Nigeria, has been reported to have one of the highest adult DM prevalence rates in the country. [14, 15] no published data to date has been documented on DM among the pediatric populations in Uyo, South-south Nigeria. [1] recent epidemiologic evidence has documented an increasing burden of the metabolic disorder among the pediatric age-group with regards to the disease incidence, prevalence, morbidity, and overall mortality. Type 1 DM (T1DM) was adjudged as the predominant pediatric age-group DM type, recent findings indicate an increasing trend of type 2 DM (T2DM) among the pediatric populations. In Nigeria, a similar trend of worsening DM epidemiologic indices, especially of the T1DM variant, among the pediatric populations has been reported from different regions of American Journal of Pediatrics 2020; 6(3): 327-333 the country in few published data. [14, 15] no published data to date has been documented on DM among the pediatric populations in Uyo, South-south Nigeria. The current study aimed to evaluate subjects diagnosed with pediatric DM (PDM) in the University of Uyo Teaching Hospital, South-south Nigeria
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