Treatment and long-term follow-up of patients diagnosed with type 1 diabetes mellitus before age 5

Abstract

ObjectivesThis study aimed to determine the effects of continuous subcutaneous insulin infusion (CSII) treatment on anthropometric measurements, mean HbA1c, and insulin dosage in patients diagnosed under 5 years of age and compare with multiple-dose injection therapy (MDI).MethodsChildren with type 1 diabetes mellitus, diagnosed <5 years since 2000 and their 19-year follow-up were evaluated retrospectively. Weight, height, body mass index (BMI), blood pressure, and HbA1c values were recorded for each visit.ResultsHundred and five patients (58.1% female, 41.9% male) were included in the study. Sixty-three (60 %) patients were treated by CSII and 42 (40%) by MDI. Mean age at diagnosis was 2.68 ± 1.42 and 3.29 ± 1.30 years respectively. Mean follow-up was 7.42 ± 4.76 and 6.01 ± 4.41 years respectively. For each group, weight standard deviation score (SDS) increased significantly in the first year after the diagnosis (p<0.001), and with the onset of puberty weight SDS decreased significantly (p<0.001). The trend of weight and BMI SDS changes over the years showed similar characteristics in both groups. During follow-up height SDS was similar in both groups except in Tanner stage 5. When puberty was completed, mean height SDS was 0.51 ± 1.03 in CSII and −0.31 ± 0.75 in the MDI group (p: 0.029). Mean HbA1c was significantly lower in the CSII group (7.62 ± 0.82 and 8.17 ± 1.22 respectively). Systolic and diastolic blood pressure change trends during the follow-up were also similar in both groups.ConclusionsCSII treatment had positive effects on metabolic control and height SDS in patients with early-onset diabetes without increasing BMI.

Insulin Pump Therapy vs Multiple Daily Insulin Injections for Glycemic Control in Children With Type 1 Diabetes: A Systematic Review and Meta-Analysis

“…Sources: [16,[23][24][25][26][27][28][29][30][31][32][33] Risk of bias in each article. Eleven articles were assessed: one showed a high risk of bias, six showed some concerns, and the remaining four showed a low risk of bias.…”

The role of upper middle arm circumference in the detection of malnutrition in diabetic children

“…Although it has been clearly shown that T1D causes growth and developmental retardation in the years of crystallized insulin use, it is predicted that the negative effect of the disease on the growth and development of children will decrease with the introduction of analog insulins, pump treatments, and sensors. [1][2][3][4] Children with growth retardation usually have poor glycemic control and are diagnosed early and with long-term follow-up. [5,6] In our study, it was aimed to scan the prevalence of malnutrition in children with T1D, which is considered a chronic disease, with the mid-upper arm circumference (MUAC) measurement and to compare the Z-score results used in evaluating this measurement with the body mass index-standard deviation score (BMI-SDS) of Turkish children.…”