Retrospective analysis of childhood Type 1 Diabetes patients in the Lakes Region

Purpose: Type 1 Diabetes Mellitus (T1DM); It is a chronic metabolic disease that is common in children and adolescents and is characterized by complete or partial insulin deficiency and hyperglycemia, resulting from mostly (90%) immune-mediated damage to the β-cells of the pancreas. It is the most common endocrine and metabolic disorder of childhood and adolescence. This study aimed to reveal the sociodemographic, clinical and laboratory findings at the time of diagnosis of patients followed up with a diagnosis of T1DM in the Pediatric Endocrinology Clinic of Süleyman Demirel University Faculty of Medicine, Department of Child Health and Diseases. Materials and Methods: The files of 514 patients aged between 6 months and 18 years who were followed up in our clinic between 2005 and 2023 with a diagnosis of T1DM were retrospectively examined. Demographic, clinical, anthropometric and laboratory characteristics of the patients at the time of diagnosis were recorded. As for demographic data, age at diagnosis, season of diagnosis, gender, family history of diabetes (T1DM, T2DM, MODY), and whether there was consanguinity between parents were examined from the files. As clinical data, clinical findings at the time of admission: polyuria, polydipsia, weight loss, inability to gain weight, polyphagia, anorexia, enuresis, nocturia, weakness, constipation, abdominal pain, vomiting, respiratory distress, and confusion were recorded. As anthropometric data, the patients' body weight (kg), height (cm), and body mass index (BMI) (kg/m2) values at the time of diagnosis were recorded. BMI was calculated according to the formula developed by the World Health Organization. Height, body weight, and BMI percentiles were calculated and recorded according to the reference values study prepared by Neyzi et al. for Turkish children. As laboratory data, the patients' blood glucose, blood gas (pH, HCO3), C-peptide, insulin, HbA1c, Celiac autoantibodies (Tissue Transglutaminase Antibodies), diabetes autoantibodies (IAA, anti-GAD, ICA) at the time of diagnosis were recorded. After recording the data the patients classified according to their status about their age (0-5.9, 6-10.9, 11-18), DKA status (no acidosis, mild acidosis, moderate acidosis, severe acidosis), place of residence (Isparta center, Isparta districts, Burdur). Statistical analyzes of the study were carried out with SPSS 29.0 (IBM Incorp, Armonk, USA). In all analyses, a p value of <0.05 was considered statistically significant. Results: 203 patients who met the criteria were included in the study. The highest patient application rates were 2013 (12.8%), 2020 (12.3%) and 2021 (11.8%). Nearly half of the patients (44.3%) applied from Isparta city center, 22.7% from the districts, and the remaining (33.0%) from Burdur province. Nearly half of the patients were girls (48.8%) and the rest were boys. The rate of patients diagnosed before the age of 6 was 26.6%, the rate of patients diagnosed between the ages of 6 and 11 was 36.9%, while the rate of patients diagnosed over the age of 11 was 36.5%. The season in which patients applied to the clinic at the highest rate was autumn (29.6%). While the majority of those with a family history of diabetes had T2DM in 31%, T1DM was detected in 6.4%. More than half of the patients (53.7%) did not have acidosis at the time of admission. Severe acidosis was observed in 20.2% of the patients, moderate metabolic acidosis in 13.3%, and mild acidosis in the remainder. Among diabetes antibodies, IAA was positive in 75.4% of the patients, and Anti-GAD was observed in 64.5% of the patients. ISLET autoantibody was found positive in half of the patients (50.2%). TTGA was observed positive in a low proportion of patients (8.4%). The most common presenting symptoms of the patients were polyuria and polydipsia. The incidence rates were found to be equal (86.7%), weight loss was observed in nearly half of the patients (49.8%), while polyphagia was observed in 16.3%. Anorexia (13.3%), abdominal pain (17.7%), enuresis (23.6%) and nocturia (26.1%) were observed in similar rates. Results: In our study, no difference was found between male and female genders, consistent with the literature. Patients mostly applied to the clinic in the autumn season. The most common presenting symptoms were polyuria and polydipsia, and nearly half of the patients presented with DKA of varying severity. It is important to raise awareness as the incidence is known to increase worldwide, especially in children under the age of 5. Our study is a single center study, and multicenter studies are needed to obtain ideas across the country.