P-02: Clinical profile at presentation of type 1 diabetes in Pakistan: poor glycemic control and high complication burden- multicenter CDiC evidence
B Tahir, E Ghafoor, A Basit, , CDiC-Pakistan TeamAbstract
Introduction
Access to insulin, glucose monitoring, and structured diabetes education is limited for children and young people with type 1 diabetes in low- and middle-income countries, including Pakistan, leading to poor glycemic control and high complication rates.
Objectives
To assess glycemic control and complication burden at presentation among individuals with type 1 diabetes in a low-resource setting
Methods
This multicenter cross-sectional study was conducted across 26 centers participating in the CDiC program. A total of 4,132 children and young people with type 1 diabetes (≤25 years) were included from May 2022 to March 2026. Participants were categorized as previously diagnosed (Group 1) or newly diagnosed (Group 2) at presentation. Baseline demographic and clinical data, including HbA1c, acute and chronic complications, and clinical characteristics at presentation, were collected using a standardized electronic database.
Results
Among previously diagnosed individuals (Group 1, n=2,808), mean age was 14.9 ± 5.3 yrs with a mean diabetes duration of 4.7 ± 3.9 yrs; males comprised 54.2%. Among those with duration >5 yrs, hypertension, nephropathy, neuropathy, and retinopathy were observed in 3.0%, 1.6%, 5.8%, and 5.1%, respectively. In newly diagnosed individuals (Group 2, n=1,324), mean age was 11.5 ± 5.7 yrs with a similar gender distribution. Mean HbA1c was 11.22 ± 2.40% in Group 1 and 12.08 ± 2.36% in Group 2. Diabetic ketoacidosis (DKA) occurred in 54.9% of newly diagnosed individuals, while 44.6% of previously diagnosed individuals reported a history of DKA.
Conclusions
Children and young people with type 1 diabetes in Pakistan present with poor glycemic control and a high burden of acute and chronic complications. The high frequency of DKA at diagnosis highlights gaps in early detection and timely access to care. Strengthening early diagnosis, improving awareness, and expanding access to structured diabetes care programs are essential to reduce preventable morbidity in low-resource settings.