Ahu PAKETÇİ, Sezer ACAR, Hale TUHAN, Yıldız GÖREN, Ece BÖBER, Korcan DEMİR, Ayhan ABACI, Gönül ÇATLI, Ahmet ANIK

Tip 1 Diyabetes Mellitus Olgularının Tanı Anındaki Demografik, Klinik ve Laboratuvar Özelliklerinin Değerlendirilmesi

Amaç: Tip 1 diyabetes mellitus tanılı 0.5-18 yaş aralığındaki hastaların demografik, klinik ve laboratuvar özelliklerinin değerlendirilmesi amaçlandı.Gereç ve Yöntemler: Çalışmaya Ocak 1999-2014 Haziran tarihleri arasında tip 1 diyabetes mellitus tanısı alan 282 pediyatrik olgu (133’ü kız, 149’u erkek) alındı. Hastalar, tanı yaşı (0.5-5.99 yaş, 6.0-10.99 yaş ve 11.0-18.0 yaş) ve tanı yılına (Ocak 1999-Aralık 2003, Ocak 2004-Aralık 2008 ve Ocak 2009- Haziran 2014) göre üç gruba ayrıldı. Tanı yılı, tanı yaşı, tanı mevsimi, cinsiyet, başvuru anındaki semptomlar ve laboratuvar bulguları bu üç grup arasında karşılaştırıldı.Bulgular: Çalışmaya tip 1 diyabetes mellitus tanılı 133’ü (%47.2) kız (ortalama yaş, 7.8±3.7 yıl), 149’u (%52.8) erkek (ortalama yaş, 9.0±4.2 yıl) olan toplam 282 tip 1 diyabetes mellitus (ortalama yaş, 8.5±4.0 yıl) tanılı olgu dahil edildi. En sık başvuru semptomları sırasıyla poliüri, polidipsi ve kilo kaybı olarak saptandı. Tanı anındaki diyabetik ketoasidozis sıklığı % 43.3 olarak saptandı. Hastaların en sık olarak (% 64.2) sonbahar ve kış mevsimlerinde tanı aldığı saptandı. Zirve tanı yaşı aralıkları 4-6 yıl (%18.1) ve 8-10 yıl (%17.0) olarak saptandı.Sonuç: Çalışma, literatür verileri ile uyumlu olarak, ülkemizde de tip 1 diyabet hastalığının görülme sıklığının yıllar içinde arttığını ve tanı yaşının düşme eğiliminde olduğunu desteklemektedir. Bu sonuçlar bölgesel özellik taşımakla birlikte ülkemizde yapılan diğer çalışmalar ile uyumlu bulunmuştur.

Anahtar Kelimeler:

Çocukluk çağı, Mevsim, Prevelans, Tip 1 diyabetes mellitus, Türkiye

Evaluation of Demographic, Clinical and Laboratory Features of Cases with Type 1 Diabetes Mellitus at Diagnosis

Objective: The aim of this study was to evaluate the demographical, clinical and laboratory features of patients with type 1 diabetes mellitus aged 0.5-18 years.Material and Methods: This study included 282 pediatric cases (133 females, 149 males) diagnosed with type 1 diabetes mellitus between January 1999 and June 2014. Patients were divided into three groups according to age at onset (0.5 to 5.99 years, 6.0 to 10.99 years, 11.0 to 18.0 years) and date of onset (January 1999-December 2003, January 2004-December 2008, and January 2009-June 2014). Date and age of diagnosis, seasons of diagnosis, gender, symptoms at admission, and laboratory findings were analyzed and compared in these groups.Results: A total of 282 children diagnosed with type 1 diabetes mellitus (mean age 8.5±4.0 years), 133 (47.2%) female (mean age 7.8±3.7 years) and 149 (52.8%) male (mean age 9.0±4.2 years) were included in the study. The most frequent symptoms were polyuria, polydipsia, and weight loss, respectively. The frequency of diabetic ketoacidosis at onset was 43.3%. The patients were diagnosed most frequently (64.2%) in the autumn and winter. The peak age range at onset was 4-6 years (18.1%) and 8-10 years (17.0%). Conclusion: This study, in line with the literature, suggests that the incidence of type 1 diabetes has increased and the age of diagnosis at onset has decreased over the years in our country. These results were found in line with other studies carried out in our country as well although reflecting regional characteristics

Keywords:

Childhood, Season, Prevalence, Type 1 diabetes mellitus, Turkey,

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Curtis JA, Hagerty D. Managing diabetes in childhood and adolescence. Can Fam Physician 2002;48:499-502.
Haller MJ, Atkinson MA, Schatz D. Type 1 diabetes mellitus: Etiology, presentation, and management. Pediatr Clin North Am 2005;52:1553-78.
Hanas R, Donaghue K, Klingensmith G, Swift PG; International Society for P, Adolescent D. ISPAD Clinical Practice Consensus Guidelines 2006-2007. Pediatr Diabetes 2006;7:341-2.
Maahs DM, West NA, Lawrence JM, Mayer-Davis EJ. Epidemiology of type 1 diabetes. Endocrinol Metab Clin North Am 2010;39;481- 97.
Shashaj B, Sulli N. Difference in insulin usage patterns with pubertal development in children with type 1 diabetes during transition from multiple daily injection to continuous subcutaneous insulin infusion (CSII) and through the CSII treatment. Diabetes Technol Ther 2009;11:767-74.
Yeşilkaya E, Cinaz P, Andıran N, Bideci A, Hatun Ş, Sarı E, et al. First report on the nationwide incidence and prevalance of the type 1 diabetes among children in Turkey. Diabet Med 2016;34:405-10.
Karvonen M, Pitkaniemi M, Pitkaniemi J, Kohtamaki K, Tajima N, Tuomilehto J. Sex difference in the incidence of insulin-dependent diabetes mellitus: An analysis of the recent epidemiological data. World Health Organization DIAMOND Project Group. Diabetes Metab Res Rev1997;13:275-91.
Weets I, De Leeuw IH, DuCaju MV, Rooman R, Keymeulen B, Mathieu C, et al. The incidence of type 1 diabetes in the age group 0-39 years has not increased in Antwerp (Belgium) between 1989 and 2000: Evidence for earlier disease manifestation. Diabetes Care 2002;25:840-6.
Xin Y, Yang M, Chen XJ, Tong YJ, Zhang LH. Clinical features at the onset of childhood type 1 diabetes mellitus in Shenyang, China. J Paediatr Child Health 2010;46:171-5.
Stipancic G, Sepec MP, Sabolic LL, Radica A, Skrabic V, Severinski S, et al. Clinical characteristics at presentation of type 1 diabetes mellitus in children younger than 15 years in Croatia. J Pediatr Endocrinol Metab 2011;24:665-70.
Kalliora MI, Vazeou A, Delis D, Bozas E, Thymelli I, Bartsocas CS. Seasonal variation of type 1 diabetes mellitus diagnosis in Greek children. Hormones (Athens) 2011;10:67-71.
Ardicli D, Kandemir N, Alikasifoglu A, Ozon A, Gonc N.Clinical characteristics of type 1 diabetes over a 40 year period in Turkey: Secular trend towards earlier age of onset. J Pediatr Endocrinol Metab 2014;27:635-41.
Gamble DR, Taylor KW. Seasonal incidence of diabetes mellitus. Br Med J 1969;3:631-3.
Moltchanova EV1, Schreier N, Lammi N, Karvonen M. Seasonal variation of diagnosis of Type 1 diabetes mellitus in children world wide. Diabet Med 2009;26:673-8.
Levy-Marchal C, Patterson CC, Green A, Europe EASG, Diabetes. Geographical variation of presentation at diagnosis of type I diabetes in children: The EURODIAB study. European and Diabetes. Diabetologia 2001;44:75-80.
Ergür AT, Oçal G, Berberoğlu M, Adıyaman P, Sıklar Z, Aycan Z, et al. Celiac disease and autoimmune thyroid disease in children with type 1 diabetes mellitus: Clinical and HLA-genotyping results. J ClinRes Pediatr Endocrinol 2010;2:151-4.