An evaluation of clinical and epidemiological characteristics and autoantibody status of children with type 1 diabetes mellitus at presentation

Abstract

Aim: The purpose of this study was to examine clinical and epidemiological characteristics and autoantibody status of children diagnosed with type 1 diabetes mellitus (DM) at presentation. Methods: The data retrieved from the medical records of 80 patients with type 1 DM, aged under 18 and diagnosed at the Adıyaman Education and Research Hospital, pediatric endocrinology clinic and emergency department between September 2016 and December 2021 were examined retrospectively. Patients’ symptoms at presentation and clinical and laboratory findings were recorded. Results: Thirty-four (42.5%) of the children with type 1 DM were girls and 46 (57.5%) were boys, with a mean age of 10.69±4.75 years. The presentation was most common in the 5-10 (33.8%) and 10-15 (31.3%) age groups. Diabetic ketoacidosis (DKA) was present in 36 (45%) of the children with type 1 DM at presentation, ketosis without acidosis in 30 (38%), and only hyperglycemia in 14. Sixty percent of the patients under five years of age, 48% of those in the 5-10 age group, and 33.3% of the 10-18 age group presented with DKA, and the frequency of presentation with DKA was higher among patients under five years of age than in the other age groups. Severe DKA findings were present in 13 (36%) cases, moderate findings in 10 (27.8%), and mild findings in 13 (36.1%). Anti-glutamic acid decarboxylase positivity was present in 14 cases (53.2%), islet cell antibody positivity in 37 (48%), and anti-insulin antibody positivity in 11 (14.2%). Conclusion: The incidence rate of DKA in children with newly diagnosed type 1 DM and the rate of severe ketoacidosis among them are quite high in the province of Adıyaman. This shows the need to continue diabetes awareness programs and to reach a larger number of people.