Department of Paediatrics, School of Medicine, International Medical University, Wilayah Persekutuan, Kuala Lumpur, Malaysia.
Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
Front Endocrinol (Lausanne). 2021 Mar 8;12:606018. doi: 10.3389/fendo.2021.606018. eCollection 2021.
Children with Type 1 diabetes (T1DM) commonly present in diabetic ketoacidosis (DKA) at initial diagnosis. This is likely due to several factors, one of which includes the propensity for T1DM to be misdiagnosed. The prevalence of misdiagnosis has been reported in non-Asian children with T1DM but not in Asian cohorts.
To report the rate of misdiagnosis and its associated risk factors in Malaysian children and adolescents with T1DM.
A retrospective analysis of children with T1DM below 18 years of age over a 10 year period was conducted.
The cohort included 119 children (53.8% female) with a mean age 8.1 SD years. 38.7% of cases were misdiagnosed, of which respiratory illnesses were the most common (37.0%) misdiagnosis. The rate of misdiagnosis remained the same over the 10 year period. Among the variables examined, younger age at presentation, DKA at presentation, healthcare professional (HCP) contact and admission to the intensive care unit were significantly different between the misdiagnosed and correctly diagnosed groups (p <0.05).
Misdiagnosis of T1DM occurs more frequently in Malaysian children <5 years of age. Misdiagnosed cases are at a higher risk of presenting in DKA with increased risk of ICU admission and more likely to have had prior HCP contact. Awareness of T1DM amongst healthcare professionals is crucial for early identification, prevention of DKA and reducing rates of misdiagnosis.
儿童 1 型糖尿病（T1DM）在初始诊断时常表现为糖尿病酮症酸中毒（DKA）。这可能是由于多种因素造成的，其中之一包括 T1DM 易误诊。T1DM 误诊的发生率已在非亚洲儿童中报道过，但在亚洲人群中尚未报道。
报告马来西亚儿童和青少年 T1DM 误诊的发生率及其相关危险因素。
对 10 年间 18 岁以下 T1DM 患儿进行回顾性分析。
该队列纳入了 119 名（53.8%为女性）平均年龄 8.1±SD 岁的患儿。38.7%的患儿被误诊，其中最常见的误诊疾病是呼吸系统疾病（37.0%）。在 10 年间，误诊率保持不变。在所检查的变量中，就诊年龄较小、就诊时处于 DKA、与医疗保健专业人员（HCP）接触以及入住重症监护病房在误诊和正确诊断组之间存在显著差异（p<0.05）。
在马来西亚，T1DM 误诊更常见于<5 岁的儿童。误诊病例发生 DKA 的风险更高，入住重症监护病房的风险更高，且更有可能有过 HCP 接触。医疗保健专业人员对 T1DM 的认识至关重要，可促进早期识别、预防 DKA 并降低误诊率。
