Endocrine Abstracts

In 2010 non-communicable diseases were shown to be the most important cause of mortality worldwide on the WHO global status report, with diabetes the 4th most common disease causing death. Type 1 diabetes Mellitus (T1DM) is the most common form of diabetes in children and young people. There is a paucity of data regarding T1DM in children in West Africa, in particular in The Gambia.

Aim: To explore the clinical presentation and outcome of children with T1DM admitted to The Edward Francis Small Teaching Hospital (EFSTH) in The Gambia, West Africa.

Method: Retrospective case note review of patients admitted to EFSTH over a 4-year period from January 2009 to December 2012.

Results: Nineteen children were admitted with a diagnosis of T1DM with or without diabetic ketoacidosis (DKA) within the time period, 15 of which were first presentations. 12 patients were documented to be in DKA on presentation, 9 that were new diagnoses of T1DM. 2 of the newly diagnosed patients, found to be in DKA were also found to have severe malaria. The most common presenting symptoms were abdominal pain, polyuria or fever, with only two patients reporting the typical clinical triad of polyuria, polydipsia and weight loss. Blood glucose measurement was performed in all patients but urinalysis only in 11 of the 19 identified. There was one mortality in the cohort of patients, the remaining 18 survived to discharge.

Although the incidence of T1DM in developing countries is known to be increasing the numbers in this study are small. This gives a glimpse into how varied and vague the presentation of T1DM is in The Gambia and how minimal the clinical resources are. Further study is needed on a wider scale to assess the true incidence and prevalence of the disease.