ESPE Abstracts (2018) 89 P-P3-082

Clinical Presentation and Autoimmune Markers in Children and Adolescents with Familial Type 1 Diabetes Mellitus (FT1DM) and Familial Type 2 Diabetes Mellitus (FT2DM)

Fawzia Alyafeia, Ashraf Solimana, Fawziya Alkhalafa, Amal Sabta, Reem Waseefa, Nagwa Aldarsya & Mona Algamalb

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).

Table 1
Familial DiabetesFMT1DMFMT2DM
Anti-insulin AB31.57%50%*
Anti GAD +ICA256.5%*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 TFT28.26%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/ml19.8%*0%
ATT Igg >10 U/ml15.4%*0%
PH <7.335.21%0%
HCO3 <1530.85%*0%
0 to 4 years40.7%0%
5 to 9 years31.48%0%
10 to 14 years27.78%100%*

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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