Incidence of Type 1 diabetes mellitus in children between 2011-2021 in Tokat province and breakdown of patients

Introduction: Type 1 Diabetes Mellitus (Type 1 DM) is a chronic metabolic disease characterized by insulin deficiency and hyperglycemia, which occurs as a result of autoimmune damage to the β-cells of the pancreas. Environmental, genetic and socioeconomic variables are important factors in the development of the disease. In this study, it was aimed to determine the incidence of Type 1 DM in children aged 0-18 between January 1, 2011 and December 31, 2021 in the province of Tokat and to examine the clinical, demographic and laboratory characteristics of the children with this diagnosis at the time of diagnosis. Materials-Methods: The files of 147 pediatric patients who were followed up with the diagnosis of Type 1 DM in Tokat Gaziosmanpaşa University Faculty of Medicine Hospital and state hospitals in the city center and districts of Tokat were retrospectively analyzed. A total of 147 pediatric patients were included in the study. The annual incidence of Type 1 DM between the ages of 0-18 was determined. As clinical and laboratory data, patients' gender, year of diagnosis, age of diagnosis, presence of diabetic ketoacidosis (DKA) at the time of admission, number of diabetic ketoacidosis, initial glycosylated hemoglobin (HbA1c) level, anti-glutamic acid decarboxylase (anti-GAD) antibody, islet cell autoantibody, anti insulin antibody, anti gliadin antibody immunoglobulin A (IgA), anti gliadin antibody immunoglobulin G (IgG), anti tissue transglutaminase IgA, anti tissue transglutaminase IgG, anti endomysium antibody IgA, anti-endomysium antibody IgG anti thyroid peroxidase antibody (anti-TPO), anti thyroglobulin antibody values were examined. IBM SPSS Statistics 20.0 program was used for statistical analysis. Results: Between 2011-2021, 147 newly diagnosed Type 1 DM patients were detected in the province of Tokat. The 11 year average incidence of Type 1 DM between 2011 and 2021 was 6,46/100.000 for boys, 8,92/100.000 for girls, and 7,69/100.000 for all children. The mean incidence of Type 1 DM in the first 5 years included in the study was 6,45/100,000, and the mean incidence in the last 6 years was 8,81/100,000. Of the patients included in the study, 65 (%44,2) were male and 82 (%55,8) were female. The male/female ratio was 1,2. The age of the patients at the time of diagnosis was between 1 and 17 years. The mean age at diagnosis was 9,42±4,17 years. Of 147 patients, 19 (%12,9) were between the ages of 0-4, 51 (%34,6) were between the ages of 5-9, 60 (%40,8) were between the ages of 10-14, 17 (%11,5) were over 15 years old. It was determined that %56,7 of the patients presented with diabetic ketoacidosis at the time of diagnosis. The relationship between age and presence of diabetic ketoacidosis at the time of diagnosis was evaluated, and no significant difference was found between age groups (p=0.691). During the follow-up period, it was observed that the total number of diabetic ketoacidosis was 0,86±0,98 (0-6) times on average. The mean HbA1c value of the patients at admission was 11,1±2,79 (5,2-19,9) mmol/L. Conclusion: When the data of public hospitals in Tokat province are examined, it is estimated that the incidence trend is on the rise and in the light of all these data, the expected incidence in all children aged 0-18 in Tokat in 2030 will be around 15/100.000. The frequent occurrence of DKA and high HbA1c values indicate the necessity of educational activities for the society about diabetes in our country. Particular attention should be paid to the atypical complaints of this age group due to the high rate of patients diagnosed during adolescence. Efforts to increase awareness can be increased so that there is no delay in diagnosis. Since our study is a single center study, multicenter studies are needed to have an idea about country data. Keywords: Type 1 Diabetes Mellitus, Incidence, Autoantibody, Pediatrics