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Type 1 Diabetes Mellitus Patients Clinical, Laboratory, Sociocultural and Demographic Features of the

Year 2016, Volume: 10 Issue: 2, 112 - 119, 01.06.2016

Abstract

Objective: Type 1 Diabetes Mellitus (T1DM) is one of the most common chronic endocrine diseases of children and adolescents. The aim of this study was to evaluate the sociocultural, demographic, clinical and laboratory characteristics of a group of children with T1DM followed at the Pediatric Endocrinology Department of Keçiören Research and Educational Hospital.Material and Methods: A total of 92 patients aged 0-18 years and diagnosed with T1DM were followed-up at Keçiören Research and Educational hospital between 2007-2013. Clinical and laboratory characteristics obtained from the records included the date of birth, gender, the time of diagnosis, BMI, HbA1c levels at the time of first diagnosis, mean yearly HbA1c, the rate of hospitalization within the last year, thyroid function tests, diabetes autoantibody levels and the complications associated with this disorder. The questionnaire including questions on the educational levels, occupation, average monthly income of the parents, whether the parents were divorced or not, where they lived and whether they owned their house or not was completed by the parents.Results: 50 of the patients were boys (54.3%) and 42 were girls (45.7%). The average age at diagnosis was 9.66±4.49 years, the minimum diabetes age was 0.45 years and the maximum diabetes age was 17.6 years. The patients were mostly at the age group of 14-18 years (42.4%) followed by the age groups of 10-14 years (37%). The patients mostly presented in the winter (n=30, 32.6%) followed by spring (n=28, 304%) at the time of diagnosis. The blood glucose

References

  • Onkamo P, Vaananen S, Karvonen M, Tuomilehto J. Worldwide increase in incidence of Type I diabetes - the analysis of the data on published incidence trends. Diabetologia 1990:42;1395-403.
  • EURODIAB ACE Study Group. Variation and trends in incidence of childhood diabetes in Europe. Lancet 2000: 355;873-6.
  • Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine (Abingdon) 2014:42;698-702.
  • %5.4 suçiçeği, kabakulak ve kızamık enfeksiyonu geçirdiği öğrenilmiştir.
  • Flood TM, Brink SJ, Gleason RE. Increased incidence of type 1 diabetes in children of older mothers. Diabetes Care 1982;5:571-3.
  • Kotanko P. Type 1 diabetes and the ‘milk hypothesis’: Is there a role for insulin in mother’s milk? Diabetes Care 1997;20:233-4.
  • Paronen J, Knip M, Savilahti E, Virtanen SM, Ilonen J, Akerblom HK, et al. Effect of cow’s milk exposure and maternal type 1 diabetes on cellular and humoral immunization to dietary insulin in infants at genetic risk for type 1 diabetes. Diabetes 2000;49:1657- 65.
  • Roche EF, Lewy H, Hoey HM, Laron Z. Differences between males and females in the seasonality of birth and month of clinical onset of disease in children with type 1 diabetes mellitus in Ireland. J Pediatr Endocrinol Metab 2003;16:779-82.
  • Levy-Marchal C, Patterson CC, Gren A. EURODIAB ACE Study Group. Europe and Diabetes. Geographical variation of presentation at diagnosis of type I diabetes in children: The EURODIAB study. European and Diabetes. Diabetologia 2001;44 Suppl 3:B75-80.
  • Kawashima H, Ihara T, Ioi H, Oana S, Sato S, Kato N, et al. Enterovirus-related type 1 diabetes mellitus and antibodies to glutamic acid decarboxylase in Japan. J Infect 2004;49:147–51.
  • Bober E, Dündar B, Büyükgebiz A. Partial remission phase and metabolic control in type 1 diabetes mellitus in children and adolescents. J Pediatr Endocrinol Metab 2001:14;435-41.
  • Darcan Ş, Gökşen Şimşek D, Özen S, Tekgüç H, Aşan Ö, Coker M. 1995-2005 yıllarıarasında başvuran tip 1 diabetes mellituslu olguların demografik özellikleri. 7. Ulusal Pediatrik Endokrinoloji ve Diyabet Kongresi: 12-21 Kasım 2007, Eskişehir, Bildiri Özeti Kitabı, s. 154, 2007.
  • Khan N, Couper JJ. Low-birth-weight infants show earlier onset of IDDM. Diabetes Care 1994;17:653-6.
  • Stene LC, Magnus P, Lie RT, Sovik O, Joner G. Birthweight and childhood onset type 1 diabetes: Population based cohort study. BMJ 2001;322;889-92.
  • Kotanko P. Type 1 diabetes and the “milk hypothesis”: Is there a role for the insulin in mother’s milk? Diabetes Care 1997;20:p233- 4.
  • Mc Kinney PA. Seasonality of birth in patients with childhood type 1 diabetes in 19 European regions. Diabetologia 2001;44:B67-B74.
  • Bache I, Volund A, Bock T, Buschard K. Previous maternal abortion, longer gestation and younger maternal age decrease the risk of type 1 diabetes among male offspring. Diabetes Care 1999;22:1063-5.
  • Dahlquist GG. Vitamin D supplement in early childhood and risk for type 1 insulin-dependent diabetes mellitus. Diabetologia 1999;42:51-4.
  • Study Group. Diabetes Care 1999:22;1698-702.
  • Kandemir N, Açıkgöz E, Yordam N. The epidemiology of juvenile- onset insulin-dependent diabetes mellitus in Turkish children. Turk J Pediatr 1994; 36:191-5.

Tip 1 Diyabetes Mellituslu Hastaların Klinik, Laboratuvar, Sosyokültürel ve Demografik Özellikleri

Year 2016, Volume: 10 Issue: 2, 112 - 119, 01.06.2016

Abstract

Amaç: Tip 1 Diyabetes Mellitus (T1DM) çocukluk çağı ve adölesan dönemde en sık rastlanılan kronik endokrin hastalıklardan biridir. Çalışmada Keçiören Eğitim ve Araştırma Hastanesi Çocuk Endokrinoloji Polikliniği’nde düzenli olarak izlenen T1DM hastaların klinik, laboratuvar, sosyokültürel ve demografik özelliklerinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Çocuk Endokrinoloji Polikliniği’nde 2007-2013 yılları arasında Tip 1 DM tanısı ile düzenli izlenen T1DM tanılı 0-18 yaş arasındaki 92 hasta çalışmaya alındı. Hastaların dosyaları retrospektif olarak ilk tanı zamanı, tanı anındaki yaşları, klinik semptom ve bulguları, semptom süreleri ve biyokimyasal parametreleri açısından incelendi. Ayrıca bu hastalar son yaşları, HbA1c düzeyleri, tiroid fonksiyon testleri, diyabet otoantikor seviyeleri, son bir yılda hastaneye yatış oranları, hastalıkla ilgili görülen komplikasyonlar, eşlik eden hastalıklar açısından değerlendirildi. Ayrıca ailelere yapılan anket ile anne ve babaların eğitim düzeyleri, meslekleri, aylık ortalama maddi gelirleri, anne ve babanın ayrı olup olmadığı, hangi evde yaşadıkları belirlendi.Bulgular: Hastalarımızın 42’si (%45.7) kız, 50’si (%54.3) erkek hastaydı. İlk tanı anında yaş ortalaması 9.66 ± 4.49 yıl; en düşük diyabet yaşı 0.45 yıl, en yüksek diyabet yaşı ise 17.6 yıldı. Hastalar yaş dağılımına göre en fazla 14-18 yaş grubunda (%42.4) daha sonra 10-14 yaş (% 37) grubundaydı. T1DM tanısı en sık kış mevsiminde (n=30,%32.6), ikinci sıklıkla ilkbahar mevsiminde (n=28,%30.4) konulmuştur. Tanı anındaki kan şekerleri 235 mg/dl-800 mg/dl (ortalama 454mg/dl ± 134 mg/dl) ve HbA1c değerleri %11.8 ± %2.9 (%6.9-19.0)’di.Sonuç: Tüm dünyada T1DM insidansının artmakta olduğu ve tanı konulma yaşının giderek düştüğü kabul edilmektedir. Kötü kontrollü T1DM hastalarda erken dönemde mikrovasküler komplikasyonlar gelişebilmektedir. Ayrıca T1DM’lu hastalarda eşlik eden otoimmün hastalıkların (çölyak hastalığı ve haşhimoto tiroidit )görülme sıklığı artması nedeni izlemde bu açıdan dikkatli olunmalıdır.

References

  • Onkamo P, Vaananen S, Karvonen M, Tuomilehto J. Worldwide increase in incidence of Type I diabetes - the analysis of the data on published incidence trends. Diabetologia 1990:42;1395-403.
  • EURODIAB ACE Study Group. Variation and trends in incidence of childhood diabetes in Europe. Lancet 2000: 355;873-6.
  • Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine (Abingdon) 2014:42;698-702.
  • %5.4 suçiçeği, kabakulak ve kızamık enfeksiyonu geçirdiği öğrenilmiştir.
  • Flood TM, Brink SJ, Gleason RE. Increased incidence of type 1 diabetes in children of older mothers. Diabetes Care 1982;5:571-3.
  • Kotanko P. Type 1 diabetes and the ‘milk hypothesis’: Is there a role for insulin in mother’s milk? Diabetes Care 1997;20:233-4.
  • Paronen J, Knip M, Savilahti E, Virtanen SM, Ilonen J, Akerblom HK, et al. Effect of cow’s milk exposure and maternal type 1 diabetes on cellular and humoral immunization to dietary insulin in infants at genetic risk for type 1 diabetes. Diabetes 2000;49:1657- 65.
  • Roche EF, Lewy H, Hoey HM, Laron Z. Differences between males and females in the seasonality of birth and month of clinical onset of disease in children with type 1 diabetes mellitus in Ireland. J Pediatr Endocrinol Metab 2003;16:779-82.
  • Levy-Marchal C, Patterson CC, Gren A. EURODIAB ACE Study Group. Europe and Diabetes. Geographical variation of presentation at diagnosis of type I diabetes in children: The EURODIAB study. European and Diabetes. Diabetologia 2001;44 Suppl 3:B75-80.
  • Kawashima H, Ihara T, Ioi H, Oana S, Sato S, Kato N, et al. Enterovirus-related type 1 diabetes mellitus and antibodies to glutamic acid decarboxylase in Japan. J Infect 2004;49:147–51.
  • Bober E, Dündar B, Büyükgebiz A. Partial remission phase and metabolic control in type 1 diabetes mellitus in children and adolescents. J Pediatr Endocrinol Metab 2001:14;435-41.
  • Darcan Ş, Gökşen Şimşek D, Özen S, Tekgüç H, Aşan Ö, Coker M. 1995-2005 yıllarıarasında başvuran tip 1 diabetes mellituslu olguların demografik özellikleri. 7. Ulusal Pediatrik Endokrinoloji ve Diyabet Kongresi: 12-21 Kasım 2007, Eskişehir, Bildiri Özeti Kitabı, s. 154, 2007.
  • Khan N, Couper JJ. Low-birth-weight infants show earlier onset of IDDM. Diabetes Care 1994;17:653-6.
  • Stene LC, Magnus P, Lie RT, Sovik O, Joner G. Birthweight and childhood onset type 1 diabetes: Population based cohort study. BMJ 2001;322;889-92.
  • Kotanko P. Type 1 diabetes and the “milk hypothesis”: Is there a role for the insulin in mother’s milk? Diabetes Care 1997;20:p233- 4.
  • Mc Kinney PA. Seasonality of birth in patients with childhood type 1 diabetes in 19 European regions. Diabetologia 2001;44:B67-B74.
  • Bache I, Volund A, Bock T, Buschard K. Previous maternal abortion, longer gestation and younger maternal age decrease the risk of type 1 diabetes among male offspring. Diabetes Care 1999;22:1063-5.
  • Dahlquist GG. Vitamin D supplement in early childhood and risk for type 1 insulin-dependent diabetes mellitus. Diabetologia 1999;42:51-4.
  • Study Group. Diabetes Care 1999:22;1698-702.
  • Kandemir N, Açıkgöz E, Yordam N. The epidemiology of juvenile- onset insulin-dependent diabetes mellitus in Turkish children. Turk J Pediatr 1994; 36:191-5.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Other ID JA22TH59FH
Journal Section Research Article
Authors

Hilal Aydın This is me

Nesibe Andıran This is me

Derya Buluş This is me

Elif Yağlı This is me

Publication Date June 1, 2016
Submission Date June 1, 2016
Published in Issue Year 2016 Volume: 10 Issue: 2

Cite

Vancouver Aydın H, Andıran N, Buluş D, Yağlı E. Tip 1 Diyabetes Mellituslu Hastaların Klinik, Laboratuvar, Sosyokültürel ve Demografik Özellikleri. Türkiye Çocuk Hast Derg. 2016;10(2):112-9.


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