Characteristics at diagnosis of type 1 diabetes in children younger than 6 years

J Pediatr. 2006 Mar;148(3):366-71. doi: 10.1016/j.jpeds.2005.10.029.

Abstract

Objective: To characterize the prodrome, presentation, family history, and biochemical status at diagnosis of type 1 diabetes mellitus (T1D) in children under age 6 years.

Study design: This was a retrospective chart review of patients hospitalized at diagnosis with T1D from 1990 to 1999 in a children's hospital.

Results: A total of 247 children were hospitalized, 44% of whom presented in diabetic ketoacidosis (DKA). When stratified by 2-year age intervals, only total carbon dioxide (tCO(2)) was significantly lower in the youngest children (P = .02), and the duration of candidiasis was significantly longer in those children presenting in DKA (P = .004). Parents were more likely to recognize symptomatic hyperglycemia in children older than 2 years (P < .0001). Most parents sought care for their child suspecting that the child had diabetes; the other children were diagnosed when presenting with another concern. Only gender and tCO(2) were significantly correlated with hemoglobin A1c (HbA1c); age-adjusted HbA1c was 0.64% higher in girls compared with boys (P = .045), and each 1-mmol/L decrement in tCO(2) increased the age- and gender-adjusted HbA1c by 0.086% (P < .001).

Conclusions: A high proportion of children under age 6 years present critically ill at the diagnosis of T1D. When any of the classic symptoms of diabetes or a yeast infection is present, a serum glucose level should be measured.

MeSH terms

  • Blood Glucose / analysis
  • Boston / epidemiology
  • Candidiasis / epidemiology
  • Carbon Dioxide / blood
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetic Ketoacidosis / epidemiology
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Multivariate Analysis
  • Parents
  • Patient Acceptance of Health Care
  • Primary Health Care
  • Retrospective Studies
  • Sex Factors

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Carbon Dioxide