Frequency and characteristics of complications and concomitant diseases in children with type 1 diabetes mellitus who fell ill in preschool age

BACKGROUND: Type 1 diabetes mellitus (DM1) is a chronic disease, the main causes of disability, mortality and decreased quality of life in which are acute and chronic complications. The onset of T1DM in childhood is associated with a significant reduction in life expectancy and a higher risk of cardiovascular complications. In addition, the chronic course of T1DM is often accompanied by other autoimmune diseases (autoimmune thyroiditis (AIT), celiac disease), as well as concomitant conditions (growth retardation, dyslipidemia, etc.), which have independent significance.

AIM: To assess the frequency and provide clinical characteristics of complications, concomitant diseases and conditions in children with T1DM who fell ill during preschool age.

MATERIALS AND METHODS: A single-center, cross-sectional study including data from 396 children aged 4 to 18 years with previously diagnosed T1DM, according to generally accepted criteria, for a duration of at least 3 and no more than 10 years on intensified insulintherapy. Depending on the age of diagnosis of T1DM, study participants were divided into two groups: group with manifestation of T1DM <7 years and group with manifestation of T1DM ≥7 years.

RESULTS: Median age was 11.9 [9.3; 14.9] years, disease duration 5.2 [3.9; 6.9] years, glycated hemoglobin level 7.9 [7.2; 9.2] %. Study groups did not differ in gender, disease duration or SDS BMI. The level of glycated hemoglobin (p=0.011) and height SDS (p=0.041) were higher in children with onset of T1DM over 7 years of age. According to the results of regression analysis, taking into account the correction for the age of children at the time of examination, a direct relationship was established between the manifestation of T1DM in preschool age and retinopathy (β=4.95), MAU (β=2.64) and growth retardation (height SDS less than 2 ) (β=1.22). In contrast, a decrease in GFR was associated with an older age at onset of T1DM (p=0.012). After adjustment for age, the incidence of AIT, celiac disease and dyslipidemia did not differ significantly depending on the age of diagnosis of T1DM.

CONCLUSION: The data obtained indicate the importance of the manifestation of T1DM in preschool age as an independent risk factor for vascular complications in children and slower linear growth. Although the exact causes are not fully understood today, these data indicatethe need for more careful and strict monitoring of T1DM in young children, starting from the very onset of the disease.

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