Comprehensive Evaluation of Sibling Cases with Type 1 Diabetes

Öz

Objective: Type 1 diabetes mellitus (T1DM) is a polygenic disease influenced by genetic, environmental, immunological factors.There are few studies regarding siblings with T1DM.We aimed to evaluate the presentation, diagnosis, follow-up, sociodemographic characteristics of sibling T1DM cases. Material and Methods: We retrospectively reviewed characteristics of sibling cases followed with T1DM between January 2005 and May 2017. Results: The prevalence of T1DM sibling diabetes in our clinic was 5.9%.We included 17 siblings (a total of 34 cases) who had diagnosis and follow-up data. One of the siblings was a twin.There were no statistically significant differences between the ages at diagnosis, presenting symptoms, duration of symptoms before diagnosis, glucose/C-peptide values at diagnosis, average HbA1c values in the first five years of follow-up, or hospitalization rates in the first five-years post-diagnosis between the first and second diagnosed siblings.Despite having a child diagnosed with T1DM, 23.6% of families had a second child diagnosed with diabetic ketoacidosis.Variations in antibody positivity were observed among siblings, there were no similarities between celiac disease, Hashimoto’s thyroiditis.Vitamin D levels were significantly lower in siblings diagnosed secondarily. Conclusion: Our study is significant for being conducted at a reference center with a high number of diabetes patients under follow-up, for filling a gap in the literature with a detailed evaluation of sibling cases with T1DM.It serves as a comprehensive pilot study examining the manner, order of diagnosis, clinical, laboratory, and follow-up data of siblings with diabetes.There is a need for prospective studies with a larger number of sibling cases to further explore this topic.

Anahtar Kelimeler

• Type 1 diabetes mellitus
• diabetic siblings
• vitamin D

Tip 1 Diyabetli Kardeş Olguların Kapsamlı Bir Şekilde Değerlendirilmesi

Öz

Amaç: Tip 1 diyabetes mellitus (T1DM) genetik, çevresel ve immünolojik nedenlere bağlı poligenik bir hastalıktır. Kardeş T1DM’ler ile ilgili az sayıda çalışma vardır. Çalışmamızda, izlemimizdeki kardeş T1DM olguların başvuru, tanı, izlem, sosyodemografik özelliklerini değerlendirmeyi, olası ortak ve farklı özellikleri tespit etmeyi amaçladık. Gereç ve Yöntemler: Ocak 2005-Mayıs 2017 arasında T1DM tanısı ile izlemimizde olan, kardeş olguların; başvuru, klinik, laboratuar, izlem, sosyoekonomik özellikleri retrospektif olarak dosya verilerinden tarandı. Bulgular: Kliniğimizde T1DM kardeş diyabet sıklığı %5.9’du. Tanı ve izlem verileri olan T1DM’li 17 kardeş (toplam 34 olgu) çalışmaya dahil edildi. Kardeşlerden biri ikiz idi. İlk ve ikinci tanı alan kardeşlerin tanı yaşları, başvuru yakınmaları, tanı öncesi yakınma süreleri, tanıdaki glukoz/C-peptid değerleri, takipteki ilk beş yıl ortalama HBA1c değerleri, tanı sonrası ilk beş yıllık izlemde hastaneye yatış sayıları arasında istatistiksel olarak anlamlı fark saptanmadı. Evde T1DM tanılı çocuk olmasına rağmen, ailelerin %23.6’sında ikinci çocuğun da diyabetik ketosiadoz (DKA) ile tanı aldığı, T1DM’li kardeşler arasında antikor pozitiflikleri açısından farklılıklar olduğu, tanı-takipte Çölyak hastalığı-Hashimoto tiroiditi açısından benzerlik olmadığı, ikinci tanı alan kardeşlerin D vitamin düzeylerinin ilk tanı alan kardeşlerden anlamlı düzeyde düşük olduğu saptandı. Sonuç: Çalışmamız; takipteki diyabetli hasta sayısının oldukça yüksek olduğu referans bir merkezde yapılmış olması, literatürde kardeş T1DM’ler ile ilgili detaylı bir değerlendirmenin bulunmaması, kardeş diyabetli olguların tanı alma şekli, tanı alma sırası, klinik, laboratuar ve izlem verilerinin değerlendirildiği kapsamlı bir pilot çalışma olması nedeni ile önemlidir. Konu ile ilgili daha fazla sayıda kardeş olgu ile yapılacak prospektif çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

• Tip 1 diyabetes mellitus
• diyabetli kardeş
• D vitamini

Kaynakça

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