Type 1 diabetes-related epidemiological, clinical and laboratory findings. An evaluation with special regard to autoimmunity in children

OBJECTIVE: To evaluate our data related with epidemiologic features, clinical presentation, and laboratory findings in children with type 1 diabetes mellitus (DM1) and to compare specific characteristics of immune-mediated subtype (DM 1A) with idiopathic one (DM 1B).

METHODS: We classified 115 children with DM1 according to the presence (DM 1A, n=77) or absence (DM 1B, n=38) of diabetes-related autoantibodies in Akdeniz University Hospital, Turkey from January 2000 to December 2005.

RESULTS: A total of 43 patients (37%) in the whole group, had onset of DM1 during the winter months and the lowest frequency occurred in summer (p<0.005). The duration of breast-feeding, introduction time of cow's milk, and seasonal distribution of birth-month or onset of disease did not significantly differ in both groups. When compared with patients who had no documented honeymoon period, the patients who had a documented honeymoon period had lower HbA1c levels (p<0.01) at the onset. A large percentage of patients with DM 1A were positive for glutamic acid decarboxylase antibody (GAD65).

CONCLUSION: There was no significant difference between patients with DM 1A and DM 1B with respect to epidemiologic features, and clinical presentation suggested that these factors do not play a major role either in creating a disease-initiating effect or in the development of islet autoimmunity. However, determination of GAD65 with HbA1c levels at the onset of the disease may ensure some useful information regarding clinical course.