Type 1 diabetes in pre-school children - long-term metabolic control, associated autoimmunity and complications

Y. Levy-Shraga*, L. Lerner-Geva, V. Boyko, C. Graph-Barel, K. Mazor-Aronovitch, D. Modan-Moses, O. Pinhas-Hamiel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Aims To identify clinical characteristics and co-morbidity rates of children diagnosed with Type 1 diabetes mellitus at younger than 6years of age. Methods Data were obtained from a retrospective chart review of 103 patients diagnosed with Type 1 diabetes at younger than 6years (study group) and 220 patients at older than 6years (comparison group). Measures of glycaemic control and occurrence of co-morbidities (coeliac disease, autoimmune thyroid disease, hypertension, nephropathy and retinopathy) were compared. Results The mean follow-up period was more than 8years. For the study group, mean HbA1c levels ranged from 64mmol/mol to 66mmol/mol (8.0-8.2%) until age 10years, and then rose to 73mmol/mol (8.8%). The HbA1c levels were higher in the study than in the comparison group for comparable ages (P=0.003). After adjustment for duration of diabetes this difference was not significant. The overall rate of severe hypoglycaemic events was greater in the study group than in the comparison group (P=0.03). Kaplan-Meier diagnosis rates of celiac disease, 10years after Type 1 diabetes diagnosis, were 14.4% and 4.2% in the study and comparison groups, respectively (P log-rank=0.03). There were no differences in rates of autoimmune thyroid disease, hypertension, nephropathy or retinopathy. Conclusions Children diagnosed with Type 1 diabetes before the age of 6years were in greater risk of developing celiac disease, compared with children diagnosed after the age of 6years. For children diagnosed with Type 1 diabetes aged under 6years, good metabolic control was achievable until age 10years, after which it deteriorated. Higher HbA1c levels observed in children diagnosed before the age of 6years were associated with longer duration of disease.

Original languageEnglish
Pages (from-to)1291-1296
Number of pages6
JournalDiabetic Medicine
Volume29
Issue number10
DOIs
StatePublished - Oct 2012

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