Objective and hypotheses: To answer the question of whether the age of diabetes onset is shifting to younger ages and whether the rate of DKA at presentation has changed over the 15 years in children with T1DM.
Method: Patients with T1DM from a single center for Pediatric Endocrinology and Diabetes in Turkey since 1999 were included. In a period of 15 years, 517 patients (249 females) were divided into three groups due to the year of diabetes diagnosed (group 1=19992003, n=75; group 2=20042008, n=190; and group 3=20092013, n=252).
Results: The mean age of diabetes onset was 8.4±4.1 years in the total cohort (0.617.7). In three groups, the mean ages of diabetes onset were 7.2±4.2, 8.0±3.7 and 9.0±4.3, respectively (P=0.002). Mean age of diabetes onset was significantly higher in the 20092013 group. The percentage of patients diagnosed under 4 years of age were 28.0, 16.3 and 13.9%, respectively (P=0.016). Diabetic diabetic ketoacidosis (DKA) and severe DKA rates at onset of diabetes (n=329) were 52.3 and 10.6%, respectively in the total cohort. There was no significant difference in DKA and severe DKA rates between three groups. The mean age of patients with DKA was younger than the patients without DKA (8.0±4.0 vs 9.3±4.2, P=0.04). The mean age of the patients with severe DKA was 6.7±3.5 years. There was a positive correlation between the age of diabetes onset and HCO3 level (r: 0.222, P:<0.001). Diabetes onset <4 years of age patients had HCO3 level significantly lower than that of >4 years of age (11.7±6.8 vs 15.1±7.4, respectively, P=0.002).
Conclusion: In this cohort there is no evidence for shifting the age of onset in T1DM getting younger in the last 15 years. Younger age at presentation with T1DM is associated with more severe acidosis.
18 Sep 2014 - 20 Sep 2014