Background: Type 1 diabetes mellitus (T1DM) is one of the most common chronic disease in childhood. Evaluation of the factors that have impact on the glycemic control and developement of complications would help to develop preventive strategies for management of this group of patients.
Objective and hypotheses: To evaluate epidemiological, presenting and follow up characteristics and their relationship with glycemic control in pediatric T1DM patients from Southeastern Anatolian Region of Turkey.
Method: Hospital records of pediatric T1DM patients being followed at Diyarbakir Childrens State Hospital and Diyarbakir Gazi Yasargil Training and Research Hospital were retrospectively reviewed.
Results: Number of patients recruited was 538 (292 female, 246 male). Mean age of diagnosis was 8.2±4.3 years. The frequency of presentation with diabetic ketoacidosis (DKA) was 51.9% with no gender discrepancy (Presentation with DKA:54.1% vs 49.1%, P=0.303), while patients with diabetes history at their families had lower rate of DKA at presentation (The rate of DKA: 47.3% vs 58.7%, P=0.040). Mean HbA1c level of female (9.6±2.2) and male (9.2±2.2) subjects at last follow-up visit was not different (P=0.079). While, HbA1c levels in prepubertal patients was significantly lower than those of pubertal group (Mean HbA1c: 8.9±1.6vs.9.7±2.2, P=0.000). Glycemic control for patients who were living at rural or urban area were also not statistically different (Mean HbA1c: 9.5±2.4 vs 9.4±2.2, P=0.616). Maternal and paternal education status was not found related to glycemic control (P value: 0.267 and 0.087). Celiac disease was associated to T1DM in 40 out of 375 (10.7%) and Hashimotos thyroiditis in 30 out of 463 (6.5%) patients. Diabetic nephropaty was the most common chronic complication detected in 24 out of 212 (11.3%). Rate of diabetic nephropaty for prepubertal and pubertal subjects was not different (P=0.169).
Conclusion: In our cohort about half of patients was presented with DKA which was lower in cases with history of diabetes at their families. Puberty was related to poor glycemic control, while rate of complications did not differed with regard of pubertal status.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology