Introduction and Objectives: Type 1 DM is a chronic metabolic disease. Its incidence is rising worldwide. We studied demographic criteria, risk factors and epidemiology of children with type 1 DM attending our diabetes control clinic.
Methods: This cross sectional study was conducted over 3214 children between 118 years who are diagnosed with type 1 diabetes and following up in DEMPU clinic, Cairo university childrens hospital. Between April 2017April 2018 all patients who attended the diabetes follow up clinic were included. History taking including age, age at diagnosis, gender, place of birth and living, consanguinity, family history, order of index case, socioeconomic status, vitamin D administration, feeding in first 6 month, time of weaning, mode of presentation, complications of DM and receiving diabetes education. Thorough clinical examination including anthropometric measures, assessment of diabetes complications and/or comorbidities. Thyroid profile, microalbumine in urine, TTG, mean lipid profile, mean HbA1c during the preceding year were recorded from files.
Results: The mean age was 10.7±3.65 years, 48% females and 52% males. Consanguinity was positive in 37% of cases. 64% of cases had positive family history of a first degree member with diabetes. The order of index case was highest for the 2nd childe (33%). Mean diabetes duration was 40 months (range=195 months). 89% of cases hadnt receive vitamin D supplements (P=0.01). 70% were exclusively breast fed while 7% had early introduction of cow milk<12 months. 58% presented with DKA and required ICU admission for a mean of 12.8 hours ±4.2. Highest rate of presentation occurred in winter (45% P=0.02). Full course diabetes education was delivered to 74% of the patients and their caregivers. Regarding measurements, mean height SDS and weight SDS were 0.32±2.6 and 0.38±1.2 respectively. Mean HbA1c during follow up was 8.2±1.8%. Logistic regression statistics study used in this study to come out the most labile risk factors for type 1 DM. the study used the HbA1c level as an indicator for the risk factor. The study confirmed cow milk introduction before 1 year as a statistically significant risk factor (P<0.0001).
Conclusion: Proper community awareness regarding type 1 DM to lessen the DKA at presentation. Improve vitamin D status among children, encourage exclusive breast feeding for the 1st 6 months and prevent cow milk intake before the age of 1 year.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology