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Prevalence of ketoacidosis at diagnosis of childhood onset Type 1 diabetes in Wales from 1991 to 2009 and effect of a publicity campaign.
- Source :
-
Diabetic medicine : a journal of the British Diabetic Association [Diabet Med] 2012 Dec; Vol. 29 (12), pp. 1506-9. - Publication Year :
- 2012
-
Abstract
- Aims: To determine the proportion of cases of childhood Type 1 diabetes that present with ketoacidosis and any temporal trend. To assess the impact of a publicity campaign promoting earlier diagnosis.<br />Methods: We used an all-Wales register of incident cases with data on 2046 children from 1991 to 2009. The proportion with ketoacidosis at diagnosis was compared with the Yorkshire Childhood Diabetes Register. On World Diabetes Day posters were sent to every pharmacy, school and general practitioner surgery across Wales and radio interviews given. A questionnaire survey was conducted in Gwent to assess penetrance of the campaign.<br />Results: Annually, in 1991-2009 the proportion presenting with ketoacidosis varied between 20% and 33% (mean 25%) with no change over time. Similar proportions occurred in Yorkshire. Ketoacidosis was more common before age 5 years (37% of cases) than at age 5-9 years (20%) or 10-14 years (23%) (P < 0.001). From November 2006-2007 30% of cases presented with ketoacidosis and from November 2007-2008 25% cases presented with ketoacidosis. After the campaign (November 2008-2009) 26% presented with ketoacidosis (P = 0.72). The information had reached a low proportion of families. General practitioners referred immediately cases that presented to them.<br />Conclusions: Over 20 years in Wales there has been no change in the proportion of children with Type 1 diabetes initially presenting with ketoacidosis. This presentation occurs in a higher proportion of new cases aged under 5 years. Publicity to increase awareness did not reduce the proportion with ketoacidosis at diagnosis in Wales. We need to get the educational message through to parents to reduce ketoacidosis at presentation.<br /> (© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.)
- Subjects :
- Age Factors
Child
Child, Preschool
Diabetes Mellitus, Type 1 diagnosis
Diabetes Mellitus, Type 1 prevention & control
Diabetic Ketoacidosis diagnosis
Diabetic Ketoacidosis prevention & control
Early Diagnosis
Female
Health Knowledge, Attitudes, Practice
Humans
Infant
Male
Odds Ratio
Prevalence
Risk Assessment
Wales epidemiology
Diabetes Mellitus, Type 1 epidemiology
Diabetic Ketoacidosis epidemiology
Health Promotion
Marketing of Health Services methods
Subjects
Details
- Language :
- English
- ISSN :
- 1464-5491
- Volume :
- 29
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Diabetic medicine : a journal of the British Diabetic Association
- Publication Type :
- Academic Journal
- Accession number :
- 22413738
- Full Text :
- https://doi.org/10.1111/j.1464-5491.2012.03638.x