Sociodemographic characteristics and infection frequency in patients with Type 1 diabetes mellitus

Type 1 diabetes mellitus is the most common endocrine-metabolic disorder at childhood and adolescence. In the present study, it was aimed to assess sociodemographic characteristics and frequency of infection in children with Type 1 DM. The present study included 184 children and adolescent with Type 1 DM. The patient charts were retrospectively reviewed and a questionnaire was applied including sociodemographic characteristics of the patients, season at diagnosis, data regarding management, hospitalization for diabetic ketoacidosis (DKA) within prior year and history of infection. Of the cases included, 53.5% were girl whereas 46.7% were boy with a mean age of 12.71±0.31 years. Mean age at diagnosis was 7.71±0.29 years while mean Hb1ac value was 8.45±1.78. It was seen that HbA1c value increased with advancing age (r: 0.30; p=0.0001). The patients were most commonly diagnosed at winter. No correlation was found between mean HbA1c value and family history for diabetes mellitus, household size, residency and monthly income. Mean HbA1c value was lower in patients attending to regular control visits (p=0.001). DKA was present at diagnosis in 52.2% of patients, while recurrent DKA rate was 2.1%. There was a significant difference in BMI when compared to baseline. It was observed that 29 patients who reached to final height passed over their height. It was found that microalbuminuria and neuropathy increased as mean HbA1c value increases. Although microalbuminuria increased with diabetic age, no significant relationship was found between neuropathy and diabetic age. Of the cases with available antibody titers, there was positive anti-GAD antibody in 89.5% of 68 cases, while anti-insulin antibody positivity in 52.8% of 123 cases and islet cell antibody positivity in 59.1% of 44 cases. There was hypothyroidism in 16 of the patients while thyroid auto-antibodies were found to be positive in 10.8%. There was a comorbid celiac disease in one case (0.54%). There was no severe infection requiring hospitalization. The mean number of infection per year was 2.3 without any increase in the infection rate. In conclusion, duration of disease and increased age, puberty, socioeconomic status, incompliance to dietary recommendation and failure in attending control visits were identified as risk factor for metabolic control in patients with Type 1 DM. It was found that patients reached to target height by improved metabolic control. The increase in BMI was striking. This could be due to administration of supraphysiological insulin doses for improved metabolic control or escalation of insulin doses beyond the control of the clinician. No increase in infection rate or severe infection requiring hospitalization was observed in our patients