P-397: Seasonal trends and delays in diagnosis: analyzing the gap between symptom onset and hospital admission
R DyAbstract
Introduction
Diagnostic delays in Type 1 Diabetes Mellitus (T1DM) remain a critical challenge in resource-limited settings, often leading to life-threatening diabetic ketoacidosis (DKA).1,2 Seasonal variations in healthcare-seeking behavior and access to medical care may further contribute to fluctuations in the timeliness of diagnosis across the year.3
Objectives
To characterize the delay between symptom onset and hospitalization, to assess clinical severity at the time of admission, and to describe the seasonal variation in new-onset T1D presentations in a pediatric hospital from 2020-2025.
Methods
The study was conducted at a pediatric hospital from 2020–2025. Data collected included date of symptom onset, date of hospitalization, DKA severity and month of admission. The primary outcome was the duration (in days) from symptom onset to hospitalization.
Results
Amoung 43 children, the median delay was 7 days (mean 9.3 ± 8.8 days; range 1–30 days).34 out of 43 patients (79.06%) were in diabetic ketoacidosis. 32 (74.41%) had moderate DKA, 1 (2.32%) had mild DKA, 1 (2.32%) with severe DKA requiring mechanical ventilation. Regarding seasonal distribution, 28 admissions (65.1%) occurred during the rainy season (June–November),15 admissions (34.9%) during the cool/dry season (December–June). This finding suggests a predominance of new-onset T1D presentations during the rainy season in our cohort.
Conclusions
In this study, the majority presented in DKA (79.06%), reflecting a critical gap in early recognition and timely referral. This estimate is similar to those reported 10 to 20 years ago from several European countries. 5, 6, 7, 8 The higher burden of admissions during the rainy season warrants further investigation into potential environmental or infectious triggers. This is similar to the study of Cameroon.9 Targeted interventions to reduce diagnostic delay could substantially decrease DKA-related morbidity and mortality in this population.