title: Pattern of presentation in type 1 diabetic patients at the diabetes center of a university hospital.
abstract: OBJECTIVE
  Diabetes mellitus (DM) is a major health problem worldwide. This study aimed to investigate the pattern of presentation and complications of pediatric diabetes.
  
  
  METHODS
  Retrospective study of children treated at a diabetes clinic at a university hospital for diabetes over 12-year period.
  
  
  METHODS
  We collected data on the age at onset, sex, clinical presentation, duration of symptoms before diagnosis, and partial remission rate that were obtained from the hospital medical records, the National Diabetes Registry, and the statistics department.
  
  
  RESULTS
  Of 369 diabetic children, most (n=321) children had polyuria (92%) 321/369=87% as the presenting symptom; other symptoms included polydipsia (310 patients, 88.8% 310/369=84%), weight loss (292 patients, 83.9%), nocturia (240 patients, 68.8% 240/369=65%), diabetic ketoacidosis (DKA) (174 patients, 49.9% 174/369=47.20%), and abdominal pain (172 patients, 49.3% 174/369=46.6%). Presenting symptoms were missing in 20 files, so the percentages were calculated among 349 patients. Most patients had acute diabetic complications such as hypoglycemia (222 patients, 62%) and DKA (88 patients, 38.1%, but none had severe complications such as coma and cerebral edema. Chronic complications included retinopathy (4 patients, 1.3%), neuropathy (2 patients, 0.6%), coronary heart disease (2 patients, 0.6%), and nephropathy (1 patient, 0.4%).
  
  
  CONCLUSIONS
  The pattern of presentation of type 1 diabetes has changed as the incidence of DKA has decreased; unlike in previous studies, DKA was not the most common presenting symptom in this study. Chronic complications of diabetes, such as retinopathy, neuropathy, coronary heart disease, and nephropathy are mostly rare but still present. These complications might be prevented by achieving better awareness of the need for glycemic control.
authors.affiliation: Department of Pediatrics, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia. drarrashed@hotmail.com
authors.forename: Abdulaziz M
authors.initials: AM
authors.lastname: Al Rashed
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D048909:Diabetes Complications / Q000453:epidemiology* / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D016883:Diabetic Ketoacidosis / Q000453:epidemiology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000209:etiology; D007223:Infant; D008297:Male; D011141:Polyuria / Q000453:epidemiology* / Q000209:etiology; D012042:Registries; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology