{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:28:10Z","timestamp":1786739290569,"version":"build-2736575974"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>This study was conducted to investigate the pathway from first symptoms to initiation of insulin regimen in children with new-onset Type 1 Diabetes Mellitus (T1DM) and explore the reasons behind diabetes ketoacidosis (DKA) at onset among children with T1DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>An exploratory study was conducted using a pretested questionnaire, among parents of children diagnosed with T1DM within preceding 3 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Out of the total 105 children, 56.1% were males. The median age was 7 years. The commonest reported symptoms were polydipsia (97.8%), polyuria (75.2%), and nocturia (75.2%). The mean time taken by parents from onset of symptoms to decide to visit the physician (appraisal gap) was 7.85 \u00b1 7.95 days. The help-seeking gap (from decision-making to visiting a physician) was 3.01 \u00b1 8.31 days, diagnostic gap (from first visit to diagnosis) was 4.19 \u00b1 6.72 days, and the treatment gap (from diagnosis to the start of insulin) was 2.12 \u00b1 6.87 days. The DKA at onset (was present in 39 out of 105 children 37.1%) and was higher among children with lower per-capita income (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      -0.017), lack of previous experience among parents (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      -0.017), longer appraisal (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      -0.023), and treatment gap (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      -0.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Increasing awareness about the diabetes among children among the public and primary healthcare workers can help prevent DKA at onset.<\/jats:p>\n                  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