MORTALITY AMONG CHILDREN AND YOUNG ADULTS WITH TYPE 1 DIABETES MELLITUS IN GHANA, A TEN-YEAR REVIEW

Abstract

Introduction: Acute complications of diabetes, particularly diabetic ketoacidosis (DKA) and hypoglycemia, can be fatal if misdiagnosed and hence not appropriately managed. This study was a 10-year mortality audit in children, adolescents, and young adults with T1DM attending the Pediatric and Adolescent Diabetes Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana. Methods: A mortality audit consisting of a review of the medical records of participants and verbal interviews with caregivers and physicians in other hospitals who also attended to some participants just before death. The period spanned from January 2012 to December 2021.   Results: A total of 14 patients out of 355 died within the 10 years giving a mortality rate of 3.9%. Seventy-one percent (71.4%) were females. The mean age at diagnosis was 12.9 5.2 years (Range: 8-14 years). The mean duration of diabetes before mortality was 7.4  2.7 years (Range: 2-13 years). The mean age at death was 19.7 3.8 years (Range: 15-28 years). Up to 50% of the participants died in district and teaching hospitals while the other 50% died at home. The identified causes of death included DKA, chronic renal failure, and osteosarcoma for those who died in hospitals.  Conclusion: Mortality among children and young adults with T1DM occurred at all levels of health care with misdiagnosis of DKA as a significant cause. Most of the children and young adults with diabetes died at home and specific causes of death could not be found.