Objectives: Type 1 diabetes mellitus (DM) is an autoimmune disease caused by the destruction of pancreatic beta cells. The frequency of Type 1 DM is increasing, and the highest incidence rate is in children under 5 years of age. It is estimated that children under the age of five will develop approximately 70% of the cases under the age of 15, with an increased incidence.
In our study, we aimed to evaluate the demographic, clinical and laboratory features of Type 1 DM patients diagnosed in our clinic during the last eight years.
Materials and Methods: The study included 323 Type 1 DM patients aged 1-18 years, diagnosed and followed in our pediatric endocrinology outpatient clinic at our Erciyes University School of Medicine. The anthropometric measurements, physical examination and laboratory findings of the patients at the time of the diagnosis were evaluated. The results were compared according to the gender, age and clinical presentation of the patients.
Results: 50.2% of the patients were female and 49.8% were male. The number of cases diagnosed under five years of age was 73 (22.6%) and the number of cases over 5 years of age were 250 (77.4%). In the 42.4% of the cases, there were a diabetes history in the family. According to the clinic at admission, 44.6% of the patients presented with diabetic ketoacidosis. 44.2% of the patients presenting with ketoacidosis had severe ketoacidosis (pH <7.10). 70% of children with severe diabetic ketoacidosis were under 5 years of age. Thyroid autoantibodies were positive in 10% and anti-endomysial antibody was positive in 8.5% of the patients. There were no significant difference in HbA1c levels between the patients without acidosis and patients with mild, moderate or severe ketoacidosis. C-peptide values were decreased in patients with ketoacidosis while acidosis worsening. When we grouped the patients according to the age at diagnosis, the mean age of the patients with severe acidosis under the age of five years was smaller (P<0.005) while the average age of the patients with mild acidosis was smaller in patients over 5 years of age.
Conclusion: Similar to other autoimmune diseases, it is noteworthy that the diagnosis of diabetes has increased and the age of diagnosis has shifted to the earlier. In accordance with the literature, the frequency of diabetic ketoacidosis in our study was found to be higher as the age decreased.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology