Delayed Management of Insulin-Dependent Diabetes Mellitus in Children.
Emir Tas, Katrin Wooley, Vildan Tas and 1 others
PMID 35977849WHAT IT FOUND
18.8% of children admitted for new insulin-dependent diabetes had delayed diagnosis, including misdiagnosis as breathing, stomach or urinary problems.
DKA occurred in 49%, more often in young children and type 1 diabetes.
Key findings
0118.8% of admitted children with new-onset insulin-dependent diabetes had delayed diagnosis, including 11.7% misdiagnosed and 7.1% mismanaged.
0249% of all patients presented with DKA, and DKA was significantly more frequent in children aged 0 to 5 years and in those with T1D.
03Patients whose diabetes was misdiagnosed presented with DKA more often than patients whose diabetes was correctly diagnosed but mismanaged, 71% vs 6%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only children admitted to the hospital for new insulin treatment were included, so the study does not describe children managed as outpatients or diagnosed elsewhere. The analysis relied on electronic records and caregiver reports about prior provider visits, so some pre-admission delays or misdiagnoses could be missed. It was a single-year retrospective study in Arkansas, so rates may not apply to other places or years. The authors note that T2D incidence is likely underestimated because some T2D patients with lower HbA1c were managed as outpatient and excluded. The death involved one patient and several treatments, so it cannot establish cause.
Declared interests
The supplied metadata lists NIH extramural research support. The provided article text does not include a conflicts of interest or funding declaration.
The easy way to misread this
Do not conclude that dexamethasone alone caused the death. The patient also received intramuscular penicillin, and the paper reports only one such case. It does not separate the contribution of each treatment.