Background: Fulminant type 1 diabetes (FT1D) is presented as a severe diabetes subtype among adults, however, we have no idea whether its worth being taken seriously among children and adolescents.
Objective and hypotheses: We aim to clarify the clinical significance of the subtype. Its supposed that we may neednt pay special attention to the subtype.
Method: Casecontrol study design. Data from hospitalized all new type 1 diabetes (T1D) patients from January 2004 to December 2012. We obtain 11 cases as experimental group, whereas the classic type as control group. We match controls according to sex, age, onset season, and year with a ratio of 1:4. We study the clinical features, laboratory parameters and follow-up for 1 year in both groups.
Results: Among 853 cases, there are 468 classic T1D patients onset with DK or DKA. Eleven cases (boys vs girls=6:5) are in line with FT1D criteria. FT1D incidence is account for 1.29% of all classic T1D, and 2.35% of T1D with DK or DKA onset. Five patients with FT1D have honeymoon period. Compared with the control group, BMI (17.89±2.64) vs (15.33±1.90), P<0.05. Incidence of FT1D group vs control group: severe DKA 40 vs 17%, insulin dose when the patients were discharged from hospital for 34 weeks 0.63 vs 0.59 (IU/kg per day), honeymoon period rate 45 vs 43% and average duration 113 vs 135 days, electrolyte index when diagnosed initially K+(4.2±1.0) vs (4.3±0.6) mmol/l, Na+135 (118144) vs 134 (119143) mmol/l, P values are ≥0.05.
Conclusion: Incidence of FT1D below 18 years old is very low. We find that additional stratification of the subtype among children and adolescents has little clinical significance.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology