Background: Type 1 diabetes mellitus (T1DM) is a complex metabolic disorder typically diagnosed in childhood and characterized by insufficient insulin production. Diabetic complications are still a major concern as they constitute the main cause of morbidity and mortality in diabetic patients despite the advances in T1DM treatment. Long-term complications of diabetes include retinopathy with potential loss of vision; nephropathy leading to renal failure; peripheral neuropathy with risk of foot ulcers; and autonomic neuropathy. Abnormalities of lipoprotein metabolism are often found in patients with diabetes.
Aim: The aim of this work was to study children with type 1 diabetes mellitus of long duration, attending the diabetes clinic of AUCH; with regard to adequacy of treatment and presence of complications.
Methods: This study was conducted on fifty children and adolescents with type 1 DM of long duration ≥5 years, attending the diabetes clinic of the AUCH. We investigated the presence of diabetic complications and their relation with the glycemic control, duration of diabetes and the age at diagnosis. All the patients were subjected to full history taking, physical examination and laboratory and radiological investigation (HbA1c, eGFR, microablumnuria, complete liver profile, lipid profile, celiac antibodies, thyroid profile, ultrasound abdomen, fundus examination and echocardiography) nerve conduction study to indicated cases.
Results: There was a significant correlation between last HbA1c and the presence of diabetic nephropathy in our cases (decreased eGFR and microalbuminuria). The use of basal bolus insulin was associated with good glycemic control and this was statistically significant.As regard the presence of fatty liver, diabetic retinopathy, lipodystrophy, there was no significant relation between last HbA1c and them. About the associated autoimmune diseases, Celiac disease was present in 10% of cases while 12% of them found to have hypothyroidism.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology