Glycaemic control, complications and associated autoimmune disease in children and adolescents with type 1 diabetes mellitus in Jeddah, Saudi Arabia

Abstract

Introduction: Type 1 diabetes mellitus (T1DM) is a common autoimmune disease among children and adolescents. The primary goal in the management of T1DM is to prevent acute and long-term complications by achieving good glycaemic control. Studies have highlighted the relation between glycaemic control and other factors, including age. Other studies have demonstrated that T1DM patients are at high risk of developing other autoimmune diseases, such as autoimmune thyroiditis and coeliac disease. On the other hand, T1DM can lead to many complications in paediatrics. Objectives: To investigate the relationship between metabolic control, acute and long-term complications and the coexistence of autoimmune diseases with T1DM among children and adolescents in Jeddah, Saudi Arabia. Materials and methods: This was a cross-sectional study that included 243 T1DM children and adolescents visiting the paediatric diabetes clinic at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Clinical and laboratory characteristics of the patients were all recorded. Metabolic control, complications and associated autoimmune diseases were evaluated. Results: The mean age of patients was 10.5±3.8 years and HbA1c level was 8.8%. Acute complications included ketoacidosis in 61.3% of the patients and hypoglycaemic attacks in 60.5%. Long-term complications included retinopathy, microalbuminuria and dyslipidaemia, which were detected in 6.2%, 16.9% and 19.3% of patients, respectively. Vitamin D deficiency was found in 77%, thyroid dysfunction was noted in 9.1% and coeliac disease in 6.2% of patients. A significant difference was found in pubertal and prepubertal age groups in terms of glycaemic control (P =0.001). Conclusions: The level of HbA 1c was found to be higher among the pubertal age group. A relationship between autoimmune diseases and gender were determined and vitamin D deficiency was highly prevalent in our population. Acknowledgements: Dr Abdulmoien Al-Agha for supervising this project.