ESPE Abstracts (2018) 89 P-P3-083

Real-world Clinical Evolution of Type 1 Diabetes Patients on Twenty Years

Amparo Gonzalez Vergaza, Beatriz Garcia Cuarterob, Laura Sanchez Saladoa, Veronica Sanchez Escuderoa, Concepción García Lacallea & Marta Fernández Férnandeza

aSevero Ochoa University Hospital, Leganés, Spain; bRamón y Cajal University Hospital, Madrid, Spain

Introduction: Type 1 diabetes mellitus (T1DM) is a chronic disease with important complications.

Objective: Describe clinical characteristics, metabolic control and comorbidities of our pediatric diabetes population.

Methods: T1DM patients diagnosed from 1996–2016 were included. Celiac and thyroid disease screening were analized.Clinical and biochemical data were compared during evolution. SPSS.21 for statistical study.

Results: 187 patients (55.6 males) were follow at least one year and 40 during more than 10 years. Mean age at onset 8.57 (0.5–15) years. (Table 1) There were no diferrences between age at onset and clinical presentation. A1cHb is lower and residual function is significant higher in those diagnosed at onset on hyperglycemia (P<0.05). 12.2% were negative for islet antibodies at clinical presentation. During evolution, 2 patients were MODY, one Wolfram syndrome and 3 developed other autoinmunities. 7.9% were still negative for inmunology All were on basal-bolus treatment, with rapid insulin analogs. From 2006, 42 patients were on ISCI. 7.48% were diagnosed for celiac disease by biopsy. Mean age 8.57 (3.9). 14.43% had thyroid disease, mean age 11.74(3.5). In 68.5% of patients mean A1 cHb were <7.5%. Severe hypoglycemia in 2.3% without differences between treatment. 6.4% developed intermittent microalbuminuria with no differences with A1C Hb but with duration of disease (Median 13 vs 6.5 years (P=0.01)). No arterial hypertension nor retinopathy were detected.

Table 1
TotalOnset 1996–2005Onset 2006–2016P value
Age onset (years )(%)
Clinical presentation (%)
Hyperglicemia with ketosis47.748.7144.4ns
A1c Hb at onset10.84 (2.48)10.7 (2.53)10.94 (2.56)ns
Peptide C ng/ml (mean SD)
Basal0.70 (0.5)0.75 (0.64)0.61 (0.44)ns
Post-glucagón Insulin treatment (%)1.28 (0.08)1.35 (1.28)1.08 (0.6)0.04
Multiple injections78.0484.4167.7
Follow up (years) (mean)6.86 (1–15.75)8.5 (2–15.75)5.83 (1–11.9)0.001
A1c Hb (% median during evolution)
Long acting-insulin analog7.657.87.65ns

Conclusions: CAD presentation reduce with time. High prevalence of associated diseases that demostrates the need for screening. Low complications with good metabolic control in most of patients. It is neccesary to re-evaluate negative inmunological patients for an etiological diagnosis.

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