Incidence of Type 2 Diabetes in Kuwaiti Children and Adolescents: Results From the Childhood-Onset Diabetes Electronic Registry (CODeR).

Background: Type 2 Diabetes (T2D) in children and adolescents has become an important public health concern due to the increase in childhood obesity worldwide. The urgency to address T2D is evident as children and adolescents are at a higher risk of complications due to prolonged disease duration. We aimed to estimate the incidence rate (IR) of T2D in Kuwaiti children and adolescents aged 14 years and younger between 2011 and 2013 and to describe their clinical characteristics at the time of diagnosis. Material and Methods: All newly diagnosed patients were registered through the Childhood-Onset Diabetes electronic Registry implemented in Kuwait. Cases who met the 2018 ISPAD guidelines for diagnosis of T2D were included. Results: A total of 32 patients were included, equally distributed gender-wise, with a mean age 12.2 years (±1.7 SD), lower for females than males (11.5 vs. 12.2, p < 0.025). Data ascertainment was 94.1% (95%CI; 91.6-96.6%). Overall IR was 2.56 (95% CI; 1.78-3.56) per 100,000 Kuwaiti children and adolescents per year. Most of the patients (n = 30; 93.8%) presented with T2D between the ages 10-14 years, with age-specific IR of 8.0 (95%CI; 5.5-11.3). No statistically significant difference between males and females with regards to BMI z scores or HbA1C at diagnosis. Conclusion: The true incidence of T2D in Kuwaiti children and adolescents is expected to be considerably higher as we have reported only symptomatic cases. Future research should focus on screening children and adolescents at risk to enable accurate estimates. More efforts are needed to better understand the clinical course of T2D early in life to improve management, prevent complications and improve quality of life.

Fasting during the holy month of Ramadan among older children and adolescents with type 1 diabetes in Kuwait.

Background To evaluate the safety of fasting during the holy month of Ramadan among children and adolescent with type 1 diabetes (T1D). Methods A retrospective cohort study of 50 children and adolescents with T1D whose mean age was 12.7 ± 2.1 years was conducted. Twenty-seven patients (54%) were on multiple daily injections (MDI) insulin regimen and 23 (46%) were on insulin pump therapy. Before fasting for Ramadan, children and their families were evaluated and educated about diabetes management during Ramadan. Hemoglobin A1c (HbA1c), weight, number of days fasted, hypoglycemia and hyperglycemia episodes, and emergency hospital visits were collected and analyzed after completing the month. Participants were compared according to the insulin treatment regimen and their glycemic control level before Ramadan. Results The children were able to fast 20 ± 9.9 days of Ramadan, and the most common cause for breaking the fast was mild hypoglycemia (7.8% among all cases). There was no significant difference between the two insulin regimen groups in breaking fast days, frequency of hypo- or hyperglycemia, weight and HbA1c changes post Ramadan. Patients with HbA1c ≤ 8.5% were able to fast more days during Ramadan with significantly less-frequent hypoglycemic attacks as compared to patients with HbA1c > 8.5 (1.2 ± 1.5 vs. 3.3 ± 2.9 days of hypoglycemia, p = 0.01, respectively). Conclusions Fasting for children with T1D above the age of 10 years is feasible and safe in both pump and non-pump users, and well-controlled patients are less likely to develop complications. Education of the families and their children before Ramadan, along with intensive monitoring of fasting children during the month are crucial.

Aseptic meningitis among children in Kuwait.

OBJECTIVE: To describe the epidemiology, clinical features, and the morbidity caused by aseptic meningitis in children in Kuwait. SUBJECTS AND METHOD: A multicenter retrospective study of previously healthy children hospitalized with a diagnosis of aseptic meningitis in the period 2001-2003 was carried out. RESULTS: There were 172 children with the diagnosis of meningitis based on changes in the cerebrospinal fluid. Aseptic meningitis was diagnosed in 86 (50%) of the cases; their mean age was 3.2 +/- 3.8 years. There were two peaks of cases, one during the months of May and June and the other in November/December. Older children (>or=5 years) presented more frequently with signs and symptoms suggestive of meningeal irritation than younger children (<5 years) (p

Epidemiology of childhood meningitis in Kuwait.

BACKGROUND: Haemophilus influenzae type b (Hib) conjugate vaccine was introduced as part of childhood routine immunization in Kuwait in 1996. The aim of this study is to describe the epidemiological, microbiological, and clinical features of meningitis among children in Kuwait from 2001 to 2003. MATERIAL/METHODS: A multicenter retrospective review of clinical records of otherwise healthy children hospitalized with a diagnosis of meningitis. RESULTS: A total of 172 children had a diagnosis of meningitis and had lumbar puncture during the study period. The median age was 8 months. The majority (67%) of the patients were less than 5 yeas of age. Eighty-six (50%) of the patients had aseptic meningitis and 19 (11%) had partially treated meningitis. The remaining 67 (39%) were diagnosed with bacterial meningitis. The underlying organisms were: Neisseria meningitidis (49%), group B streptococci (18%), Streptococcus pneumoniae (18%), Mycobacterium tuberculosis (6%), Gram-negative organisms (6%), and Haemophilus species (1.5%). Twelve percent required admission to the intensive care unit. At the time of discharge from the hospital, 9% had neurological sequelae, the majority of which were in patients who had S. pneumoniae meningitis. Two patients died during the study period. CONCLUSIONS: N. meningitidis is the leading bacterial agent of bacterial meningitis in Kuwait. S. pneumoniae is responsible for the majority of neurological sequelae of bacterial meningitis in infants and young children. The results of this study can be used in future public health planning in the context of the newly available vaccines.