Diabetes Mellitus In Children Research Articles

Prevalence of Autoimmune Thyroiditis Among Children with Type 1 Diabetes

A single-stage cross-sectional study was conducted on the basis of the National Center for Maternal Health in the Kyrgyz Republic, children aged 0 to 18 years were examined. To study the prevalence of autoimmune thyroid disease with type 1 diabetes mellitus to improve the compensation of carbohydrate metabolism in children and adolescents with type 1 diabetes. Autoimmune thyroiditis often accompanies and interferes with type 1 diabetes mellitus in children and adolescents. Thyroid dysfunction in children with type 1 diabetes mellitus can negatively affect various areas of metabolic control. This study included 60 children with type 1 diabetes mellitus and autoimmune thyroiditis, 24 of them girls (40.0%), 36 boys (60%). The average value of ±SD for their age at the time of examination was 11.6±4.1 years, ranging from 1 to 17 years. Of the children with type 1 diabetes mellitus who tested positive for antibodies to thyroid peroxidase, 30 children (50%) had obvious hypothyroidism. Of the thirty children with normal TSH levels, 4 children (13.3%) showed signs of subclinical hypothyroidism, while 26 children (86.7%) had euthyroidism.

Main epidemiological indicators of type 1 diabetes mellitus in children in the Russian Federation for 2014-2023

Type 1 diabetes mellitus (T1DM) is the most common form of diabetes mellitus in childhood, where, unlike in adults, it accounts for more than 90% of all cases of diabetes. The constant change in the epidemiology of T1DM with significant differences in populations and regions requires systematic data collection and analysis for timely monitoring of T1DM trends. Analysis of the main epidemiological indicators of T1DM in children in the Russian Federation over the past 10 years - from 2014 to 2023. The object of the study was the data obtained from the federal statistical observation form No. 12 «Information on the number of diseases registered in patients living in the service area of a medical organization» for the period from 2014 to 2023. The prevalence (total number of registered cases) and incidence (cases with a diagnosis established for the first time) of T1DM (ICD-10 code: E10) were analyzed in children in three age groups: from 0 to 14 years, from 15 to 17 years, and combined from 0 to 17 years (inclusive). Over the analyzed period, the prevalence of T1DM increased steadily from 238.6 in 2014 to 374.2 cases per 100,000 children in 2023. The prevalence of T1DM in adolescents from 15 to 17 years was higher than in children and amounted to 120.3-203.2 cases per 100,000 adolescents, while in children under 14 years of age, the prevalence was 100.1-172.2 cases per 100,000 children. The annual increase in the prevalence of T1DM averaged 6.3% (95% CI 4.9-7.8). The incidence of T1DM during the analyzed period was 19.1-27.2 cases per 100,000 children and also had a general tendency toward an annual increase in new cases. At the same time, over the past three years, there has been a relative stabilization of incidence rates at 26.5-27.2 per 100,000 children. The annual increase in incidence averaged 4.9% (95% CI 0.9-8.9). The greatest increase in the incidence of T1DM was observed in regions with low incidence. The epidemiology of T1DM in the Russian Federation is characterized by significant regional and dynamic changes. Over the period 2014-2023, the incidence of type 1 diabetes in children has increased significantly, increasing annually by an average of 5%, while there has been a relative stabilization of incidence rates over the past three years.

Association of breastfeeding and early cereal introduction with development of type 1 diabetes mellitus in children in Pakistan: Case study.

Objective: The aim of this study is to examine the association between type 1 diabetes mellitus development, breastfeeding and early cereal introduction in Pakistani children. Study Design: Case-control study. Setting: Allied Hospital in Faisalabad, Pakistan. Period: November 2023 to February 2024. Methods: Involving 220 children ranged from 2 to 10 years were selected for case (diagnosed with type 1 diabetes) and Control group (without diagnosed with type 1 diabetes). Researchers developed a questionnaire based on information about breastfeeding, cereal introduction and other factors associated with type 1 diabetes. Parents were requested to complete the questionnaire regarding their child, mother, and family. Results: The mean ages of children were slightly higher in the control group (6.2±5.5 years) compared to the case group (5.67±7.4 years). This research determined that a one-month cumulative increase in exclusive breastfeeding for the duration of the breastfeeding period decreased the individual risk by 47.8% to 13.9% less probability in type 1 DM case. Among cases, 47.8% of the children were exclusively breastfed for less than one month, which was very low, while in the control group, this proportion was lower at 30. 6%. Furthermore, more cases (22.6%) were exclusively breastfed for 6 months compared to controls (13.9%). Among cases, 45.5% of children did not consume formula, whereas in the control group, this percentage was lower at 54.2%. Additionally, a higher proportion of controls (39.8%) were introduced to the formula before 6 months compared to cases (30.0%). Cereals were introduced to 5.55% of cases and 3.12% of controls prior to six months of age. Conclusion: Children who were breastfed for a longer period of time had a lower chance of type 1 diabetes, while children who were introduced to cereal and other food at an early age had a higher risk of the disease. Extended breastfeeding lowers the risk of diabetes by offering important protective effects from birth.

New therapeutic approaches in corticosteroid-induced diabetes mellitus in children

Corticosteroid-induced diabetes is a significant complication in pediatric patients receiving steroid therapy for various medical conditions. This article reviews the pathophysiology, diagnosis, and management of corticosteroid-induced diabetes in children. Key therapeutic strategies include lifestyle modifications, pharmacologic interventions, and careful monitoring of blood glucose levels. Emphasis is placed on individualized treatment plans tailored to the child's specific needs and underlying condition. The article also discusses the importance of interdisciplinary collaboration among healthcare providers to optimize outcomes and minimize long-term complications. Early recognition and proactive management are critical in improving the quality of life for affected children.

Type 2 diabetes mellitus in children and young people: a single uk paediatric diabetes centre experience

Type 2 diabetes mellitus in children and young people: a single uk paediatric diabetes centre experience

Basic principles of treatment and follow-up of children with acute odontogenic infection and insulin-dependent diabetes mellitus

The purpose of the study is to substantiate the basic principles of treatment and clinical dental observation of children with acute odontogenic inflammatory disease and insulin-dependent diabetes mellitus as an accompanying disease. Material and methods. A medical examination was conducted for 213 children who were treated at the St. Petersburg city children’s hospital of K.A. Raukhus of. The dental status of children with insulin-dependent diabetes mellitus and children of the control group without concomitant diseases was assessed using the Fedorov-Volodkina index, the KPU index and analysis of the caries intensity according to the T.F. Vinogradova table, periodontal conditions according to the PMA index (papillary-marginal-alveolar). The state of microhemocirculation of periodontal tissues was also assessed using Doppler ultrasound and the use of a reflex cold test. In children diagnosed with “Acute odontogenic osteomyelitis of the jaws,” laboratory blood parameters, the composition of the microbial flora of wound discharge, and the length of hospitalization were studied. Results. Based on the data obtained, an algorithm for treatment and dispensary dental observation of children with diabetes was presented. The detection of diabetes mellitus in children of any age should be accompanied by increased attention to the dental health of these patients. If teeth affected by caries are identified during a preventive examination, immediate treatment is required. It is necessary to ensure constant follow-up of the child by an endocrinologist. Doppler examination of the microhemocirculatory bed vessels of the mucosa of the alveolar process of the jaw revealed that an adequate response to a reflex cold test was detected only in the control group patients, those who do not have insulin-dependent diabetes mellitus. With the development of acute odontogenic osteomyelitis of the jaw in children suffering from insulin-dependent diabetes mellitus, hospitalization is necessary when the first clinical symptoms of the inflammatory process appear. Immediately after hospitalization and immediate surgical sanitation of a purulent focus of infection in the oral cavity, drug therapy should be started: antibacterial, infusion, symptomatic, as well as insulin therapy. The results of this study are especially relevant in the treatment of children with a duration of insulin-dependent diabetes mellitus of more than 5 years and a decompensated course of endocrine disease. Conclusions. The results of the study allowed us to expand our understanding of the impact of diabetes on the oral health of children, to establish risk factors for the development of acute odontogenic osteomyelitis of the jaws in children of different age categories with insulin-dependent diabetes mellitus, as well as the characteristics of the course of odontogenic osteomyelitis of the jaws in each of the cases. Based on the identified features, the principles of diagnosis and treatment of acute odontogenic osteomyelitis of the jaws in children with insulin-dependent diabetes mellitus have been formulated.

Systematic Literature Review: Analisis Faktor Risiko Diabetes Melitus Tipe 1 pada Anak dan Remaja di Negara Maju Wilayah Eropa Barat

The incidence of type 1 diabetes mellitus mostly occurs in children and adolescents has increased significantly every year, especially in developed countries in Western Europe which continue to experience the highest increase. The purpose of this study was to analyze the risk factors for type 1 diabetes in children and adolescents in developed countries in Western Europe. This type of research is a systematic literature review. The literature search strategy as a source of information was carried out by accessing electronic databases online, namely Science Direct, PubMed, and Google Scholar. Article quality assessment using Critical Appraisal Skill Programme (CASP). The results showed that out of 10 (2014-2024), conducted in the United Kingdom (n=1), Sweden (n=1), Germany (n=1), England (n=2), Denmark (n=3), Norway (n=1) and conducted in Norway and Denmark (n=1). Of the 10 articles, 5 out of 10 articles examined BMI on the development of type 1 diabetes in children and adolescents. The results of this systematic review found that age, gender, race, family history of diabetes, socioeconomic, BMI, nutritional intake in mothers and children, physical activity, infection and smoking will increase the risk of type 1 diabetes mellitus in children and adolescents in developed countries in Western Europe.

Modifying Factors of the Incidence of Type 1 Diabetes Mellitus in Children under 18 Years of Age in Northern Spain in the Last 3 Decades

Introduction: Type 1 Diabetes Mellitus is a chronic disease of autoimmune etiology that is highly prevalent in childhood. In the last decade, the possibility of the influence of the Bacillus Calmette-Guérin vaccine, different autoimmune diseases, modification of the immune response, and COVID19 itself of a simple population change due to immigration. Objectives: The objective of this work is to study the incidence of Type 1 Diabetes Mellitus in a cohort of children from Euskadi, north of Spain in the last 15 years. Methods: For the epidemiological study in Euskadi, a comparison of accumulated incidences between vaccinated and unvaccinated population groups was made. Results: The results of our study were not conclusive, but we believe that it is necessary to continue with long-term studies to eliminate bias.

Association of the apoptotic markers Apo1/Fas and cCK-18 and the adhesion molecule ICAM-1 with Type 1 diabetes mellitus in children and adolescents

BackgroundType 1 diabetes mellitus (T1DM) is characterized by immune and metabolic dysregulation. Apo1/Fas is implicated in maintaining homeostasis of the immune system. Cytokeratin-18 (cCK-18) is a predictive marker of liver disorders in T2DM. Intercellular adhesion molecule-1 (ICAM-1) is considered to increase susceptibility to diabetes mellitus. All three markers are associated with endothelial function, apoptosis and diabetes-related complications. The possible role of Apo1/Fas, cCK-18 and ICAM-1 was investigated in children and adolescents with T1DM.MethodForty-nine (49) children and adolescents with T1DM and 49 controls were included in the study. Somatometric measurements were obtained and the Body Mass Index (BMI) of the participants was calculated. Biochemical parameters were measured by standard laboratory methods and Apo1/Fas, cCK-18 and ICAM-1 were measured using appropriate ELISA kits. The statistical analysis was performed using the IBM SPSS Statistics 23 program.ResultsApo1/Fas (p = 0.001), cCK-18 (p < 0.001) and ICAM-1 (p < 0.001) were higher in patients with T1DM compared to the controls. Apo1Fas was negatively correlated with glucose (p = 0.042), uric acid (p = 0.026), creatinine (p = 0.022), total cholesterol (p = 0.023) and LDL (p = 0.005) in the controls. In children and adolescents with T1DM, Apo1/Fas was positively correlated with total cholesterol (p = 0.013) and LDL (p = 0.003). ICAM-1 was negatively correlated with creatinine (p = 0.019) in the controls, whereas in patients with T1DM it was negatively correlated with HbA1c (p = 0.05).ConclusionsApo1/Fas, cCK-18 and ICAM-1 may be useful as serological markers for immune and metabolic dysregulation in children and adolescents with T1DM. Also, Apo1/Fas may have a protective role against metabolic complications in healthy children.

Physical development of adolescents with type 1 diabetes mellitus and the impact of the war in Ukraine on its impairment

Purpose: To determine the characteristics of physical development (PD) of adolescents with type 1 diabetes mellitus (T1DM) and the impact of the war in Ukraine on its nature. Material and methods: The nature of physical development (PD) was assessed in adolescents with T1DM aged 14–18 years, examined before the start of the war on 24.02.2022 (main group, n = 114) and after 01.10.2022 (comparison group, n=76). The study was conducted in accordance with the principles of the Declaration of Helsinki and accepted by the Committee on Bioethics and Deontology. The examination of patients was carried out in accordance with the standards of medical care “Diabetes mellitus in children”, approved by Order of the Ministry of Health No. 413 of February 28, 2023 (Order of the Ministry of Health of Ukraine, 2023) and protocol for providing medical care to children in the specialty “pediatric endocrinology” (Order of the Ministry of Health of Ukraine, 2013). Results: It was proven that 29,1% of modern adolescents 14-17 years old, patients with T1DM, had a disharmonic PD, the nature of which depended on gender and the state of glycemic control. Girls were more likely to have impaired growth (21,0%) and overweight (12,8%), while boys were diagnosed with tall stature (8,9%) and underweight (8,9%). More often, PD disturbances were observed in the case of stable decompensation of carbohydrate metabolism with a decrease in the time spent in the target range and high levels of glycemic variability during the day. Among adolescents with T1DM during the period of hostilities in Ukraine, the number of adolescents with disharmonious PD increased (36,7%, P&lt;0,05), which may be due to a deterioration in glycemic control. In boys, an increase in the percentage of patients with underweight (20,0%, P&lt;0,05) and with short stature (4,0%, P&lt;0,05) was recorded, and in girls - with overweight (29,9 %, P&lt;0,05). Conclusions: confirms the negative impact of T1DM on RF, especially when socio-economic conditions worsen during armed conflicts. The relationship between the nature of risk factors, gender, the state of glycemic control and unfavorable living conditions during the war in Ukraine was determined.

Possibilities of Skin Autofluorescence Reflecting the Characteristics of Diabetes Mellitus in Childhood

Objective: To measure skin autofluorescence in children and adolescents suffering from type 1 diabetes mellitus and evaluate its relationship with gender, age, experience and chronic complications of the disease. Materials and Methods: The study group included 47 children and adolescents with type 1 diabetes. Autofluorescence of the skin from the inner surface of the shoulder and nail of patients was measured using an original compact spectrofluorimeter based on the STS-VIS OCEAN OPTICS © USA microspectrometer with UVA excitation. Statistical analysis was carried out using StatsoftStatistica 12.0 software. The data is presented as a two-dimensional array. The UV LED signal was averaged and smoothed using the moving average method with a 10 nm window. Then the spectra were renormalized taking into account the found coefficients. The result of applying additional normalization is a decrease in the standard deviation. Results and Discussion: Significant differences were revealed in the skin fluorescence spectra of children of different ages. between age groups (5-7) and (8-12) is most significant in the region of the alpha band of oxyhemoglobin (540 nm) (p &lt;0.005). When using I-normalization, the NADH peak region (p &lt; 0.02) is significant with increasing disease duration. When studying the influence of gender factors on the level of skin autofluorescence, the most significant differences are found in the area of only the isosbestic points of deoxy and oxyhemoglobin 442 nm (p&lt;10-7) and 491 nm (p&lt;10-8). Significant differences in skin autofluorescence at the reference length were also obtained waves in the autofluorescence spectrum of 500 nm correspond to p&lt;10-14, depending on the presence of complications. Conclusion: In Russia, as well as throughout the world, there is an increase in the incidence of type 1 diabetes mellitus. For early diagnosis of changes in carbohydrate metabolism and complications of the disease, a simple, accessible, non-invasive research method is needed. Taking into account the results of our study, when creating non-invasive methods for monitoring the state of carbohydrate metabolism, it is necessary to take into account gender and age characteristics, experience and the presence of complications of type 1 diabetes mellitus.

Predictive factors of diabetic ketoacidosis in patients with newly onset type 1 diabetes: A single center study

BackgroundDiabetic ketoacidosis is a severe metabolic emergency often associated with the onset of Type 1 Diabetes Mellitus, with significant morbidity and mortality. Its incidence as the initial presentation of Type 1 Diabetes Mellitus varies widely by country. In Morocco, there is a lack of comprehensive research on the prevalence and risk factors of diabetic ketoacidosis in children with newly diagnosed Type 1 Diabetes Mellitus, highlighting the need for this study. ObjectivesThe aim of our study was to analyze the predictive factors of diabetic ketoacidosis at the onset of Type 1 Diabetes Mellitus in children and adolescents at a single medical center in Morocco to develop prevention and management strategies. MethodsA retrospective, single-center study including 200 patients aged between 1 and 18 years at Type 1 Diabetes Mellitus onset, between September 2019 and September 2023. The population was divided into two groups according to the presence or absence of diabetic ketoacidosis. Medical records provided data for analysis with SPSS v21, employing Chi-square and Student's t-tests, followed by logistic regression to identify predictors of diabetic ketoacidosis. ResultsMultivariate regression identified several factors that were significantly associated with diabetic ketoacidosis at presentation, including age below 5 years (OR: 3.98; p = 0.021 compared to 6–10 years and OR: 5.07; P = 0.003 compared to 11–18 years), rural living (OR: 2.95; p = 0.032), low family income (OR: 9.22; p < 0.001), delayed diagnosis (OR: 21.27; p < 0.001), longer symptom duration before diagnosis (OR: 1.02; p = 0.010), preceding infections (OR: 2.72; p = 0.019), and lower vitamin D levels (OR: 0.90; p = 0.011). ConclusionOur findings underscore the critical need for increased awareness, education, use of point-of-care glucose testing, and targeted interventions in rural areas, in order to reduce the incidence of diabetic ketoacidosis. We also highlight the potential role of vitamin D in increasing the risk of diabetic ketoacidosis at the onset of Type 1 Diabetes Mellitus. This study provides important information on the present state of pediatric diabetes care in our country, and suggests target points for future interventions and research.

Features of the Liver Sonoelastography Findings in Patients with Type 1 Diabetes Mellitus in Childhood

Features of the Liver Sonoelastography Findings in Patients with Type 1 Diabetes Mellitus in Childhood

ANALYSIS OF REGULATORY AND LEGAL SUPPORT FOR THE PREVENTION OF DIABETES MELLITUS IN CHILDREN

Diabetes mellitus has become one of the most prevalent chronic diseases in childhood today. International forecasts suggest that the incidence of diabetes will continue to rise in the coming decades, leading to a lifelong burden for millions of children worldwide. Therefore, prediction, prevention, and optimal treatment of diabetes, as well as early prevention of serious long-term complications, remain essential. Providing highly qualified medical care to diabetic patients is a crucial step in preventing the development of complications. The purpose of this article is to review existing research on diabetes prevention strategies for children, considering the different levels of medical care support available. Materials and Methods. This study investigates the organization of preventive care for children with diabetes in Ukraine. Researchers employed three key methods: bibliosemantic analysis, content analysis focused on analyzing Ukraine relevant regulations and legal frameworks, and the method of systemic approach and analysis to gain a comprehensive understanding of how preventive care is currently organized for children with diabetes in Ukraine. Results. In Ukraine, preventive measures and the provision of medical care to pediatric patients with diabetes in the past years and today are regulated by a number of documents and orders of the Ministry of Health. As part of the Comprehensive Program “Diabetes Mellitus” (1999) and in accordance with the Order of the Ministry of Health of Ukraine “On Improving the Organization of Providing Endocrinological Care to the Population of Ukraine” (2006), the State Register of Patients with Diabetes Mellitus (SYNADIAB) was created. The next step was the approval of the State Target Program “Diabetes Mellitus”. Subsequently, the Project of the national program “Health 2020: Ukrainian Dimension” became an effective tool, which outlined the main principles of the program implementation in the “Endocrinology” section for 2013-2020. It defined measures at all stages of diabetes prevention, such as primary prevention, which consists of maintaining and strengthening the general state of health and preventing or delaying the development of diabetes; secondary prevention should improve early detection of diabetes mellitus; tertiary prevention, which ensures the effectiveness and safety of treatment of children with diabetes to prevent the development of long-term complications. Today, the guidelines for the management of children with diabetes mellitus have been continued in such documents as “Diabetes Mellitus in Children”, Evidence-Based Clinical Guidelines (2023) and Standards of Care (2023). Conclusion. Diabetes mellitus is a chronic disease that ranks third in prevalence after cardiovascular and cancerous diseases and second in the structure of endocrine diseases after thyroid gland pathology. Today, the prevalence of diabetes mellitus among children is constantly increasing and, therefore, solving the issues associated with this disease is one of the priority tasks for the national health care system. This is because diabetes mellitus is associated with a high risk of complications leading to loss of work capacity, disability, and mortality across various population groups. Organizing high-quality medical care and establishing an effective prevention system based on the latest medical technologies is crucial. Diabetes demands attention. Understanding the risks and prevention of the disease can significantly increase the chances of protection and a long, healthy life through timely treatment.

Clinical prediction model for MODY type diabetes mellitus in children

BACKGROUND: MODY (maturity-onset diabetes of the young) is a rare monogenic form of diabetes mellitus, the gold standard of diagnosis is mutations detection in the genes responsible for the development of this form diabetes. Genetic test is expensive and takes a lot of time. The diagnostic criteria for MODY are well known. The development of clinical decision support system (CDSS) which allows physicians based on clinical data to determine who should have molecular genetic testing is relevant.AIM: Provided a retrospective analysis of clinical data of the patients with T1DM and MODY, from 0 to 18 years old, regardless of the duration of the disease to develop the model. Based on clinical data, a feedforward neural network (NN) was implemented - a multilayer perceptron.MATERIALS AND METHODS: Development of the most effective algorithm for predicting MODY in children based on available clinical indicators of 1710 patients with diabetes under the age of 18 years using a multilayer feedforward neural network.RESULTS: The sample consisted of 1710 children under the age of 18 years with T1DM (78%) and MODY (22%) diabetes. For the final configuration of NS the following predictors were selected: gender, age at passport age, age at the diagnosis with DM, HbA1c, BMI SDS, family history of DM, treatment. The performance (quality) assessment of the NN was carried out on a test sample (the area under the ROC (receiver operating characteristics) curve reached 0.97). The positive predictive value of PCPR was achieved at a cut-off value of 0.40 (predicted probability of MODY diabetes 40%). At which the sensitivity was 98%, specificity 93%, PCR with prevalence correction was 78%, and PCR with prevalence correction was 99%, the overall accuracy of the model was 94%.Based on the NN model, a CDSS was developed to determine whether a patient has MODY diabetes, implemented as an application.CONCLUSION: The clinical prediction model MODY developed in this work based on the NN, uses the clinical characteristic available for each patient to determine the probability of the patient having MODY. The use of the developed model in clinical practice will assist in the selection of patients for diagnostic genetic testing for MODY, which will allow for the efficient allocation of healthcare resources, the selection of personalized treatment and patient monitoring.

Evaluation of the Presentation of Newly Diagnosed Type 1 Diabetes Mellitus in Children During and After the COVID-19 Pandemic

Background: The COVID-19 pandemic has been a global health problem with high morbidity and mortality. In this study, it was aimed to compare the clinical and laboratory findings of patients diagnosed with type 1 diabetes(T1D) during the pandemic and after the pandemic. Method: This is a 30-month, single-center, cross-sectional study. Between October 2020 and December 2021 was defined as the pandemic period, and between January 2022 and March 2023 as the post-pandemic period. The clinical and laboratory parameters of the newly diagnosed T1D patients who applied in these two time periods were compared. Results: While 87 patients were diagnosed during the pandemic period, 86 patients were diagnosed during the post-pandemic period. The rate of male patients diagnosed during the pandemic period was significantly higher (56%, 36%, respectively, p=0.007). Anti-islet Cell antibody (ICA) positivity was statistically significantly higher in those diagnosed during the pandemic period. (52.6%, 18.6%, respectively, p&amp;lt;0.001). There was no difference between the groups in terms of hemoglobin A1C, thyroid autoantibodies and tissue transglutaminase antibodies (p&amp;gt;0.05).C peptide levels were significantly lower in those diagnosed during the pandemic period (0.39±0.4, 0.63±0.6, respectively, p=0.021). Admissions with severe acidosis were more common during the pandemic than those admitted after the pandemic (29.9%, 16.3%, respectively, p=0.151). Conclusions: The numbers of children with T1D newly diagnosed in a secondary health center were similar during and after the pandemic. In the pandemic period, admissions with autoantibody positivity, low C-peptide and severe acidosis were more common.

Epidemiology of type 1 diabetes mellitus in children and adolescents: A 50-year, single-center experience.

Global variations in epidemiology of type 1 diabetes mellitus (T1DM) exist. This study is designed to examine demographic and clinical features of T1DM over the past 3 decades as well as evolving trends in epidemiology over last 50 years. Clinical characteristics of 925 patients with T1DM over last 30 years (1990-2019) were evaluated and compared to previously published data of 477 patients diagnosed between 1969 and 1990 from one of the major referral centers for diabetes in Turkey. Mean age at diagnosis decreased from 9.5 ± 4.0 to 7.1 ± 3.6 years within the past 50 years (p < .001). Age at diagnosis peaked at 12-14 years between 1969 and 1990, then fell to 10-11.9 years between 1990 and 1999, and to 4-5.9 years between 2000-2009 and 2010-2019 (p = .005). Although the percentage of patients diagnosed <6 years of age is gradually increasing, the percentage between the ages of 6 and 11.9 years is decreasing, and the percentage diagnosed ≥12 years remained stable. A total of 47.5% of patients had ketoacidosis, 38.2% had ketosis, and 14.3% had only hyperglycemia. 23% of patients had severe diabetic ketoacidosis (DKA), whereas 42% had moderate. Over last 3 decades, there has been no change in frequency of ketoacidosis at presentation, but there has been significant decline in severity (p = .865, and p < .001, respectively). Although the frequency of patients with mild DKA increased over time, frequency of patients with moderate DKA decreased; however, no significant difference was observed among patients with severe ketoacidosis. DKA was more frequent and severe in patients <6 years of age (p = .005, and p < .001, respectively). Age at diagnosis shifted to younger ages in T1DM in the past 50 years. Half of patients had ketoacidosis at diagnosis and frequency of presentation with DKA did not decrease, but severity decreased slightly. Increase in prevalence of T1DM in the younger age group and the fact that half of patients present with DKA indicate that awareness should be increased in terms of early diagnosis and treatment.

Correlation between auto-immune diseases and type 1 diabetes mellitus in the pediatric age group in Erbil city

Background and objective: Type-1 diabetes mellitus is the most common chronic endocrine disorder of childhood and adolescence and is characterized by immune-mediated destruction of pancreatic cells, which has been proven to be correlated with and increase the risk of developing autoimmune thyroid disease, celiac disease, Addison’s disease, and further autoimmune diseases. The aim of this study is to evaluate the prevalence of autoimmune disease-related markers in type 1 diabetes mellitus in children and adolescents in Erbil city. Methods: One hundred children and adolescents with type 1 diabetes mellitus were enrolled in this cross-sectional study. Patients &lt;1 year old were excluded from the study. Autoimmune thyroid antibodies (anti-thyroid peroxidase and anti-thyroglobulin) along with tissue transglutaminase (IgA and IgG) antibodies were measured with further evaluation by thyroid function test and endoscopy with biopsy (for positive serological autoantibodies level). Results: Elevated anti-thyroglobulin, anti-thyroid peroxidase, and tissue transglutaminase IgA and IgG antibodies were determined in 24.0%, 26%, 10%, and 8%, respectively. 50.0% of cases with positive anti-thyroid peroxidase antibodies had overt hypothyroidism; on the flip side, 3.8% had subclinical hypothyroidism. As well, the high level of thyroid autoantibodies was significantly correlated to the prevalence of overt hypothyroidism (P &lt;0.001). Nine of the patients with positive tissue transglutaminase antibodies were verified to have biopsy-proven celiac disease. Conclusion: Children and adolescents with type 1 diabetes mellitus are at risk of developing positive antithyroid and celiac-related autoantibodies, so they are at risk of progressing to autoimmune thyroid and celiac diseases.

Diagnosis, Therapy and Follow-Up of Diabetes Mellitus in Children and Adolescents.

Diagnosis, Therapy and Follow-Up of Diabetes Mellitus in Children and Adolescents.

Ultrasound indicators of blood flow in the eyes and orbits at different durations of type 1 diabetes mellitus in childhood and adolescence

Diabetic retinopathy is a complication of type 1 diabetes mellitus with high social significance, especially in childhood and adolescence.Aim: To evaluate ultrasound indicators of retrobulbar blood flow at different durations of type 1 diabetes mellitus in childhood and adolescence.Material and Methods. Ultrasound examinations were performed in 70 patients with type 1 diabetes mellitus aged from 5 to 18 years, with disease duration of up to 5 years, from 5 to 10 years, and more than 10 years. The analysis included an assessment of the linear velocity of blood flow and the index of peripheral resistance in the ophthalmic arteries, central arteries and retinal veins, posterior short ciliary arteries, and ophthalmic veins at different times of the duration of type 1 diabetes mellitus.Results. The study revealed a decrease in blood flow velocity in the central retinal arteries, in the posterior short ciliary arteries with an increase in the duration of type1 diabetes mellitus. The greatest decrease in blood flow velocity was recorded in the group with duration of diabetes mellitus of more than 10 years.Conclusion. The obtained data on a decrease in blood flow velocity in the retrobulbar arteries can be used for the assessment and dynamic monitoring of early disorders of the blood supply to the eye and orbit in patients with type 1 diabetes mellitus in childhood and adolescence.