Frequency of microalbuminuria in patients with Type 1 diabetes

Type 1 diabetes mellitus is the most common endocrine disorder in the pediatric and adolescent age group, resulting from the complete or absolute absence of insulin and leading to disturbances in carbohydrate, protein, and fat metabolism. This study was conducted in the Pediatric Endocrinology Department of Trakya University Medical Faculty, Department of Pediatrics, between January 2006 and December 2021. It aimed to determine the frequency of microalbuminuria and its risk factors in patients diagnosed with T1DM with a duration of at least 1 year. The mean age of the 285 cases included in the study (55,1% male, 44,9% female) was 14,4±3,9 years, and the mean age at the time of diabetes diagnosis was 8,3±4,1 years. At the time of diagnosis, 36,8% (105) of the patients were pubertal, while at the time of the study, 81,4% (232) were pubertal. Normoalbuminuria was detected in 271 (95%) of the cases, while microalbuminuria was found in 14 (4,9%). The mean age at diagnosis for T1DM cases with microalbuminuria was 10,9±1,7 years, the mean duration of diabetes was 6,2±1,9 years, and the mean age at the time of the study was 16,8±1,6 years. In T1DM cases with normoalbuminuria, the mean age at diagnosis was 8,2±4,1 years, the mean duration of diabetes was 6,1±3,3 years, and the mean age at the time of the study was 14,2±4,0 years. Although the duration of diabetes was similar in both groups, the age at diagnosis and the age at the time of the study were significantly higher in the microalbuminuria group. The mean HbA1c level was 8,1±1,3% in the microalbuminuria group and 8,6±2,0% in the normoalbuminuria group, showing no significant difference. In terms of metabolic control, both groups had a higher number of cases with moderate glycemic control. No significant differences were found between the microalbuminuria and normoalbuminuria groups in terms of anthropometric findings and lipid levels. When the microalbuminuria cases were classified according to the age of T1DM diagnosis, no cases were found with a diagnosis before the age of 5. However, 9 cases (64,2%) were diagnosed between the ages of 5 and 11, and 5 cases (35,7%) were diagnosed at age 11 or older. Although more cases were observed in the 5-11 age range, no significant difference was found between the groups in terms of gender. In the microalbuminuria cases, according to the age of diabetes diagnosis, the duration of diabetes, mean HbA1c level, lipid profile, and total daily insulin doses were similar. When the cases were examined according to the duration of microalbuminuria, 10 (71,4%) of the 14 cases diagnosed with microalbuminuria had persistent microalbuminuria, 3 (21,4%) had transient microalbuminuria, and 1 case (7,1%) had intermittent microalbuminuria, with similar diabetes durations across the groups. Although the groups could not be statistically analyzed due to the small number of cases, the age at diabetes diagnosis and the average HbA1c level before the onset of microalbuminuria were higher in the persistent microalbuminuria group. In conclusion, the frequency of microalbuminuria in our pediatric and adolescent cases followed with a diagnosis of T1DM was found to be similar to that reported in the literature. Unlike the literature, this study identified that not only the duration of diabetes but also the age at diabetes diagnosis could be a risk factor for the development of microalbuminuria. Larger-scale and prospective studies are needed to further investigate the relationship between age at diabetes diagnosis and the development of microalbuminuria, a finding that supports this association.