Treatment and long-term follow-up of patients diagnosed with type 1 diabetes mellitus before age 5.

Abstract

This study aimed to determine the effects of continuous subcutaneous insulin infusion (CSII) treatment on anthropometric measurements, mean HbA1c, and insulin dosage in patients diagnosed under 5 years of age and compare with multiple-dose injection therapy (MDI). Children with type 1 diabetes mellitus, diagnosed <5 years since 2000 and their 19-year follow-up were evaluated retrospectively. Weight, height, body mass index (BMI), blood pressure, and HbA1c values were recorded for each visit. Hundred and five patients (58.1% female, 41.9% male) were included in the study. Sixty-three (60 %) patients were treated by CSII and 42 (40%) by MDI. Mean age at diagnosis was 2.68±1.42 and 3.29±1.30 years respectively. Mean follow-up was 7.42±4.76 and 6.01±4.41 years respectively. For each group, weight standard deviation score (SDS) increased significantly in the first year after the diagnosis (p<0.001), and with the onset of puberty weight SDS decreased significantly (p<0.001). The trend of weight and BMI SDS changes over the years showed similar characteristics in both groups. During follow-up height SDS was similar in both groups except in Tanner stage 5. When puberty was completed, mean height SDS was 0.51±1.03 in CSII and-0.31±0.75 in the MDI group (p: 0.029). Mean HbA1c was significantly lower in the CSII group (7.62±0.82 and 8.17±1.22 respectively). Systolic and diastolic blood pressure change trends during the follow-up were also similar in both groups. CSII treatment had positive effects on metabolic control and height SDS in patients with early-onset diabetes without increasing BMI.