Glycemic control,complications, and associated autoimmune diseases in children and adolescents with type 1 diabetes in Jeddah,Saudi Arabia

Objectives:

To investigate the relationship between metabolic control, acute and long-term complications, the coexistence of autoimmune diseases, and to assess the different factors that can affect the glycemic control level among children with type 1 diabetes mellitus (T1DM).

Methods:

This is a cross-sectional study that included 228 T1DM children and adolescents visiting the pediatric diabetes clinic at the King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia from January 2013 to January 2014. The clinical and laboratory characteristics of the patients were recorded. Metabolic control, complications, and associated autoimmune diseases were evaluated.

Results:

The mean age of patients was 10.99 years, and the glycated hemoglobin (HbA1c) level was 8.8%. Acute complications included ketoacidosis in 65.4% of patients, and hypoglycemic attacks in 68.9%. Long-term complications were detected in patients including retinopathy (4.4%), microalbuminuria (16.2%), and dyslipidemia (8.3%). Autoimmune thyroiditis was noted in 14%, and celiac disease was found in 19.7% of patients. A significant difference was found in pubertal and pre-pubertal age groups in terms of glycemic control (p=0.01).

Conclusion:

The level of HbA1c was found to be higher among the pubertal age group. A relationship between autoimmune diseases and gender was determined.Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in pediatric patients. The incidence of T1DM among children is rising worldwide, and varies depending on different factors. The overall annual increase is estimated at 3% with approximately 70,000 children worldwide expected to develop T1DM every year.1 In Saudi Arabia, the reported prevalence in children and adolescents was 109.5/100000 in 2008.2 Type 1 diabetes mellitus is an autoimmune disease characterized by insulin deficiency due to destruction of pancreatic beta cells. Patients with T1DM are at high risk of developing other autoimmune diseases, such as autoimmune thyroiditis (AIT) and celiac disease (CD).3,4 Moreover, T1DM can lead to numerous complications in pediatric patients, with the most common acute complications including hypoglycemia, and diabetes ketoacidosis (DKA). Long-term complications in childhood include retinopathy, nephropathy, and dyslipidemia, among others. In this study, we aimed to assess the relationships between glycemic control, acute and long-term complications, associated autoimmune diseases,and to assess other different factors that can affect or predict the glycemic control level among children with T1DM visiting the pediatric diabetes clinic at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia.