Çocukluk çağında yeni tanı almış 140 diyabet olgusunun tanı tipleri ve klinik özellikleri: tek merkez deneyimi

Abstract

Amaç: Çocukluk çağındaki diyabetes mellitusun (DM) çoğunluğunu tip 1 diyabet (T1DM) oluşturur. Ancak son yıllarda tip 2 diyabetes mellitus (T2DM) sıklığında ve monogenik diyabet (MD) tanısı koymada artış gözlenmektedir. Bu çalışmada 0-18 yaş arasında tanı konulan diyabetli hastalarda klinik ve laboratuvar bulgularının, DM tiplerinin değerlendirilmesi amaçlandı. Gereç ve yöntem: Çalışmada kliniğimizde DM tanısı alan 140 hasta retrospektif olarak değerlendirildi. Bulgular: Üç yıllık süreçte 140 hastaya (76 erkek, %54,3) diyabet tanısı konuldu. Hastaların ortalama tanı yaşı 10±4,19 yıldı. Hastaların %93,6'sına T1DM, %2,8'ine T2DM, %3,6'sına MD tanısı konuldu. Tip 1 diyabetes mellitus vakalarının 5-9 (%36,6) ve 10-14 (%37,4) yaş gruplarında zirve yaptığı görüldü. Diyabetik ketoasidoz (DKA) prevalansı %61,8 idi. Yine bu olguların %64,9'u sonbahar/kış aylarında tanı aldı. Tip2 diyabetli hastaların %75'i kadındı ve ortalama tanı yaşı 15,05±1,11 idi. Monogenik diyabetli olgularının ikisi neonatal DM, ikisi GCK-MODY ve biri CEL-MODY idi. Sonuç: Çocukluk çağı diyabet vakalarının çoğunluğu T1DM olmasına rağmen, özellikle obez ergenlerde T2DM sıklığı artma eğilimindedir. Otoantikor pozitif T1DM’li hastalarda da obezitenin olabileceği akılda tutulmalıdır. Tip1 diyabet olgularının daha çok kış mevsiminde, 10-14 yaş grubunda başvurduğu ve DKA sıklığının yüksek olduğu saptandı. Monogenik diyabet şüphesi olan olgulara genetik inceleme yapılmalıdır.

Keywords

• Diyabetes mellitus
• tip 1 diyabet
• tip 2 diyabet
• monogenik diyabet
• çocukluk çağı

Types and clinical features of 140 newly diagnosed cases of diabetes in childhood: a single-center experience

Abstract

Purpose: Type 1 diabetes (T1DM) accounts for the majority of childhood diabetes mellitus (DM). However, in recent years, there has been an increase in the prevalence of type 2 diabetes mellitus (T2DM) and the diagnosis of monogenic diabetes (MD). The aim of this study was to evaluate the clinical and laboratory findings, as well as the types of DM, in patients diagnosed between the ages of 0 and 18. Materials and methods: In the study, 140 patients diagnosed with DM in our clinic were evaluated retrospectively. Results: During the 3-year period, 140 patients (n=76, 54.3% male) were diagnosed with diabetes. The mean age at diagnosis of the patients was 10±4.19 years. 93.6% of patients were diagnosed with T1DM, 2.8% of patients with T2DM and 3.6% of patients were diagnosed with MD. It was observed that the cases of T1DM peaked in the 5-9 (36.6%) and 10-14 (37.4%) age groups. the prevalence of diabetic ketoacidosis (DKA) was 61.8%. The majority of patients 64.9% with T1DM were diagnosed in the autumn/winter months. 75% of the patients with T2DM were female, and the mean age at diagnosis was 15.05±1.11years. Two of the cases of MD were neonatal DM, two were GCK-MODY and one was CEL-MODY. Conclusion: Although the majority of childhood diabetes cases are T1DM, the frequency of T2DM tends to increase, especially in obese adolescents. It should be kept in mind that obesity may also occur in autoantibody-positive T1DM patients. It was determined that T1DM cases were more common in the winter season, in the 10-14 age group, and that DKA was higher. Genetic examination should be performed in cases with suspected MD.

Keywords

• Diabetes mellitus
• type 1 diabetes
• type 2 diabetes
• monogenic diabetes
• childhood

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