ESPE2018 Poster Presentations Diabetes & Insulin P3 (60 abstracts)
Clinical Presentation and Autoimmune Markers in Children and Adolescents with Familial Type 1 Diabetes Mellitus (FT1DM) and Familial Type 2 Diabetes Mellitus (FT2DM)
Fawzia Alyafei a , Ashraf Soliman a , Fawziya Alkhalaf a , Amal Sabt a , Reem Waseef a , Nagwa Aldarsy a & Mona Algamal b
aHamad General Hospital, Doha, Qatar; bHamad Medical Center, Doha, Qatar
Studies support the existence of a genetic contribution to both type 1 and type 2 diabetes, and additionally suggest a relationship between both types of diabetes. The rapidly growing worldwide epidemic of type 2 diabetes has been partially explained by obesity and the sedentary lifestyle. However, familial factors also seem to play a major role in the pathogenesis of type 2 diabetes.). The fact that type 1 and type 2 diabetes cluster in families suggests that some patients may even have a ‘double form’ of diabetes.
Objective: To report the clinical presentation and autoimmune markers of children and adolescents with FT1DM and FT2DM.
Patients and methods: All children with onset of FT1DM and FT2DM 2–16 years of age registered between 2012 and 2016 were studied. We those who had one or more first-degree relatives (parents and siblings) with T1DM (FT1DM) (n=108) and those with one or more first-degree relatives with type 2DM (FT2DM) (n=13). The clinical presentation and biochemical data including the prevalence of beta cell autoimmunity (Anti GAD, anti-islet cell and anti-insulin antibodies(ICA), thyroid function (Free thyroxine (FT4) and TSH), anti-thyroid peroxidase antibody (ATPO) and anti-tissue transglutaminase (ATT) at their first presentation were recorded, described and compared (Table 1).
| Familial Diabetes | FMT1DM | FMT2DM |
| Anti-GAD | 70.21% | 0% |
| ICA | 72.5%* | 42.8% |
| Anti-insulin AB | 31.57% | 50%* |
| Anti GAD +ICA2 | 56.5%* | 0% |
| Free T4 (<11 pmol/l) | 2.94%* | 0% |
| TSH (5.6–10 U/ml) | 3% | 8.3%* |
| TSH (>10 U/ml) | 0.99% | 8.3%* |
| ATPO (>100 IU/ml) | 35.5% | 30% |
| ATPO (>100 IU/ml)+Normal TFT | 28.26% | 20% |
| ATPO (>100 IU/ml)+hypothyroid (T4<11 pmol/l) or TSH >10 U/ml) | 7.7% | 0% |
| ATPO (>100 IU/ml)+(TSH 5.6–10 U/ml) | 2.2%* | 0% |
| ATPO (<100 IU/ml) +hypothyroid (T4<11 pmol/l or TSH >10 U/ml) | 1.1% | 10%* |
| ATT IgA>10 U/ml | 19.8%* | 0% |
| ATT Igg >10 U/ml | 15.4%* | 0% |
| PH <7.3 | 35.21% | 0% |
| HCO3 <15 | 30.85%* | 0% |
| Ketosis | 60%* | 0% |
| Females | 41.51% | 38.5% |
| Males | 58.50% | 61.6% |
| 0 to 4 years | 40.7% | 0% |
| 5 to 9 years | 31.48% | 0% |
| 10 to 14 years | 27.78% | 100%* |
| *P<0.05 | ||
Conclusion: Children with FT2DM had a significantly high prevalence of ICA, anti-GAD and ATPO antibodies. In addition, they did not have ketosis at their first presentation with hyperglycemia. This presence of autoimmune markers in a good number of our patients with FT2DM point out to a probable familial-genetic mixture between FT1DM and FT2DM.
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