Background: Type 1 diabetes mellitus (DMI) is a chronic disease that requires frequent visits in outpatient pediatric endocrine clinics in order to rearrange their new lives.
Objective and hypotheses: A retrospective study of patients with DMI was performed during 20082015, assessing epidemiological and clinical data, treatment and subsequent course.
Method: We analyzed the incidence, age and gender of 75 patients at the diseases onset, the HbA1c at first admission, 2, 4, 6 and 8 years of treatment and the type of insulin received. Statistical analysis was performed with SPSS.
Results: The average age of DMI onset was 7.82±3.56 years and two seasonal peaks were observed, mainly in January (33%) and April (30.6%). Initial signs were ketoacidosis (61.3%), ketosis (28%) and hyperglycemia as an incidental finding (10.7%). One single case of severe ketoacidosis was reported and no acute complication occurred during DKA treatment. The average HbA1c at the onset was 12.3±2.08% and no significant difference was found between the age groups, although all younger patients presented moderate ketoacidocis. Two years after the first diagnosis HbA1c was reduced. However, there has been an increase of HbA1c through the years, especially in puberty. The majority of patients received insulin glargine and lispro. The last year, five patients (>14 years old) started treatment with TRESIBA, as basal insulin, and five teenagers put insulin pumps, with no significant difference in their metabolic control, but with an improvement in their quality of life. Finally, after 8-year follow-up, no complication occurred.
Conclusion: The type of insulin therapy has no big effect on the diabetic control, but the proper psychological support and the education in order to deal with their new way of life is more important.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology