Early Onset of Type 1 Diabetes in Kuwait: Distinct Clinical, Metabolic, and Immunological Characteristics

Abstract

Objective: Exploring early onset diabetes in terms of describing characteristics at time of diagnosis might aid in a better understanding of etiology and may have implications on management and prevention. The aim of this study is to investigate the prevalence of early onset Type 1 Diabetes (T1D) in Kuwait as well as describe their baseline clinical, biochemical, and immunological characteristics. Methods: Medical records of children newly diagnosed with T1D and registered in the Childhood-Onset Diabetes electronic Registry (CODeR) in Kuwait between 2017-2022 were reviewed. Early onset T1D was defined as diagnosis at age younger than 6 years. Results: 2051 children were registered with new-onset T1D between 2017-2022 of which 657 (32.0%) were diagnosed at early onset. There has been a trend of slight increase in the percentage of early onset T1D after 2020 (15.2%) with a prevalence of 18.4% and 20.2% in 2021 and 2022 respectively (p = 0.056). Age at onset was inversely related to admission to the PICU (OR = 0.90, 95%CI 0.85, 0.95, p < 0.0001) and was directly related to positive celiac autoimmunity (p = 0.022), higher HbA1C (p < 0.0001) and C-peptide levels (p < 0.0001). However, age at onset of T1D was inversely related to the higher Vitamin D levels (p < 0.0001). Conclusion: These findings reinforce the need for increased attention to be given to study the development of T1D in children of younger age. This in turn will support special management and prevention measures targeted towards this vulnerable age group.