Clinical significance of typing fulminant type 1 diabetes in children and adolescents

Abstract

Objective To investigate the frequency and clinical characteristics of fulminant type 1 diabetes (FT1D) and to clarify the clinical significance of the subtype in pediatrics. Methods Case-control study designed and Data collected from hospitalized registration system. All new diagnosed type 1 diabetes (T1D) patients from January 2004 to December 2012 were enrolled. According to the diagnostic criteria, we obtained 11 FT1D cases from 853 T1D, at the same time, we match the classical type as control group according to the same gender, age(±2 years), the same season and same year with a ratio of 1∶4. We studied the clinical features, laboratory parameters and follow-up clinical outcome for at least one year in both groups. Results There were 468 classical type 1 diabetes patients onset with diabetic ketosis(DK) or diabetic ketoacidosis(DKA) among 853 cases. Eleven cases (6 boys) were in line with FT1D criteria. Frequency of FT1D accounted for 1.29% of all classic T1D, and 2.35% in T1D with DK or DKA onset. Compared with the classical group, fluminant group has no statistical significance in acute severe complications, the honeymoon rate and lasting period, abnormal electrolytes and etc, except body mass index (BMI). Conclusions Frequency of FT1D below 18 years old is very low, fluminant group shows no obvious differences compared to the classical group. However, so rare FT1D cases, we must do further study in the future to explore the clinical significance of this subgroup in pediatrics. Key words: Diabetes mellitus, type 1; Adolescent; Fulminant