BSPED2024 Oral Communications Diabetes Oral Communications 1 (5 abstracts)
Does severity of DKA presentation associate with autoantibody status, deprivation or ethnicity - a two-centre retrospective cohort
Chamila Balagamage 1 , Afiya Andrews 1 , Melanie Kershaw 1 , Zainaba Mohamed 1 , Jan Idkowiak 1,2 , Suma Uday 1,2 , Vrinda Saraff 1 , Lesley Drummond 1 , Ruth Krone 1 , Ruben H. Willemsen 3 & Renuka P. Dias 1,4
1Department of Paediatric Endocrinology and Diabetes, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United Kingdom; 2Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom; 3The Royal London Children’s Hospital, Barts Health NHS Trust, London, United Kingdom; 4Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
Background: Almost 25% of all paediatric patients present at diagnosis in DKA in the UK. DKA at presentation is associated with poorer glycaemic control in the longer-term with implications for morbidity and mortality in adulthood. It is reported that presentation in DKA is associated with younger age, socio-economic deprivation, ethnic minority background and no family history of T1D.
Aim: To explore if deprivation, ethnicity or auto-antibody (AAB) status leads to differences in presentation in 2 large centres (London and Birmingham) serving multi-ethnic populations.
Methods: Retrospective case note review of all children diagnosed with T1D over 12 months period (ending December 2023) within 2 centres. Patients were grouped according to presentation (severe DKA, mild-moderate DKA or no DKA), ethnicity (white vs non-white/mixed), Index of Multiple Deprivation (IMD) quintile and AAB status. Statistical analysis was performed with Fisher’s exact test.
Results: 75 children (32M: 43F) presented with new onset T1D. Mean age at presentation was 9.1 years (range 1-16). 25 (33.3%) were in severe DKA, 15 (20.0%) in mild/moderate DKA and 35 (46.7%) not in DKA at presentation. Mean age of presentation for severe DKA vs no DKA was 9.2 years vs 9.6 years (p = 0.63). No difference seen in severity of DKA and AAB status (severe DKAn = 4 for >=2AAB positive,n = 14 for 1AAB positive, no DKAn = 9 for >2AAB positive,n = 11 for 1AAB positive, P = 0.3). No difference seen in presentation based on ethnicity (non-white: severe DKAn = 15 vs no DKAn = 29; white: severe DKAn = 15 vs no DKAn = 21; P = 0.6). Most of the population were from the lowest IMD quintile (1-2,n = 59 vs 16 from IMD quintiles 3+) but no difference was seen in presentation comparing IMD quintiles in DKA severity (severe DKA: IMD quintile 1-2n = 20, IMD 3+n = 5, P = 0.76).
Discussion: No differences in presentation at diagnosis in DKA based on age, ethnicity or deprivation quintile were observed although our cohorts are heavily skewed in terms of ethnic diversity and deprivation compared to national data. More worryingly, patients present to our centres at diagnosis in DKA at almost twice the national average which needs further investigation.
Volume 103
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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