Clinical presentation and autoimmune characteristics of very young children at the onset of type 1 diabetes mellitus

J Pediatr Endocrinol Metab. 2010 Nov;23(11):1151-7. doi: 10.1515/jpem.2010.180.

Abstract

The aim of our study was to identify factors that are related to a more aggressive beta-cell destruction in children at presentation of type 1 diabetes mellitus (T1D). We analyzed age, HbAlc, pH, bicarbonate, IAA, IA2, GADA, C peptide of 290 consecutive patients with T1D at onset. Seventy-three (25.2%) were younger than 4 years; 217 (74.8%) were aged 4-18 years. Younger patients had lower C peptide, pH and bicarbonate than older ones. Age at T1D onset was negatively related to IAA titers (r: -0.3404, p < 0.001), positively related to IA2 titers (r: 0.1249, p: 0.03) and to C peptide (r: 0.42, p: < 0.001). Multivariable linear regression showed that C peptide was negatively related to HbA1c and positively related to age, pH at admission and IAA titers. T1D in very young children is characterized by a more extensive beta-cell destruction, and younger age at onset is related to a more severe decompensation.

MeSH terms

  • Adolescent
  • Autoantibodies / blood*
  • C-Peptide / analysis
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / immunology*
  • Diabetes Mellitus, Type 1 / metabolism*
  • Diabetes Mellitus, Type 1 / pathology
  • Female
  • Glutamate Decarboxylase / immunology
  • Glycated Hemoglobin A / analysis
  • Humans
  • Infant
  • Infant, Newborn
  • Insulin Antibodies / blood
  • Insulin-Secreting Cells / pathology
  • Linear Models
  • Male

Substances

  • Autoantibodies
  • C-Peptide
  • Glycated Hemoglobin A
  • Insulin Antibodies
  • hemoglobin A1c protein, human
  • Glutamate Decarboxylase