Incidence and clinical presentation of Type 1 Diabetes Mellitus among children and adolescents in Yanbu, Saudi Arabia

Background

Type 1 diabetes mellitus (T1DM) is one of the most common metabolic disorders in children and adolescents. Saudi Arabia is among the countries with the highest reported incidence of T1DM worldwide.

Objective

To estimate the incidence of T1DM among children and adolescents in Yanbu province, Saudi Arabia; characterize the clinical presentation and severity of diabetic ketoacidosis (DKA) at diagnosis; and analyze the distribution of cases by age group, sex, and season.

Methods

This retrospective study included all children aged 0–14 years newly diagnosed with T1DM at the Royal Commission Medical Center in Yanbu between July 2020 and June 2023. Data were extracted from medical records. Patients were categorized by age group, clinical presentation, DKA severity, and season of diagnosis. Incidence rates were calculated using 2022 Saudi Census data. Statistical analysis was performed using SPSS v26.0.

Results

A total of 108 children and adolescents aged 0–14 years were newly diagnosed with T1DM during the three-year study period. The average annual incidence was 30.8 per 100,000 (95 % CI: 26.7–35.8). The median age at diagnosis was 6.9 years (IQR: 4–9.8), with the highest proportion in the 6–<11 year age group (46.3 %). Males and females were equally represented. Most patients (68.5 %) presented with hyperglycemic symptoms, while 31.5 % had DKA; of the DKA cases, 70.6 % were mild to moderate and 29.4 % were severe. A significant association was observed between age group and clinical presentation (p = 0.009), with younger children (0–<3 years) contributing disproportionately to severe DKA cases. Seasonal variation showed more cases diagnosed in summer and spring, though not statistically significant. No mortality or major morbidity was documented.

Conclusions

Yanbu province demonstrates a high incidence of T1DM among children and adolescents. Most cases presented with hyperglycemic symptoms rather than DKA, and the majority of DKA cases were of mild to moderate severity. These findings highlight the importance of early recognition and timely management of T1DM to prevent severe complications.