Premium
Characteristics of adult‐ compared to childhood‐onset type 1 diabetes
Author(s) -
Casu A.,
Kanapka L. G.,
Foster N. C.,
Hirsch I. B.,
Laffel L. M.,
Shah V. N.,
DeSalvo D. J.,
Lyons S. K.,
Vendrame F.,
Aleppo G.,
Mastrandrea L. D.,
Pratley R. E.,
Rickels M. R.,
Peters A. L.
Publication year - 2020
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.14314
Subject(s) - medicine , diabetic ketoacidosis , pediatrics , type 1 diabetes , interquartile range , diabetes mellitus , cohort , ketoacidosis , population , comorbidity , age of onset , type 2 diabetes , overweight , cohort study , disease , body mass index , endocrinology , environmental health
Aims To compare diagnosis characteristics, diabetes management and comorbidities in a population diagnosed with type 1 diabetes in childhood with those in a similar population diagnosed in adulthood to identify disease differences related to the age of diabetes onset. Methods This analysis was performed using the T1D Exchange Clinic Registry, a cross‐sectional survivor cohort. Retrospectively collected characteristics were compared across the following age‐at‐diagnosis groups: <10, 10–17, 18–24, 25–39 and ≥40 years. Results The entire cohort included 20 660 participants [51% female, median (interquartile range) age 18 (14–36) years, 82% non‐Hispanic white]. Diabetic ketoacidosis at diagnosis was more common among those with onset in childhood. Participants diagnosed as adults were more likely to be overweight/obese at diagnosis and to have used oral agents preceding type 1 diabetes diagnosis (57%). Current insulin pump use was less frequent in participants diagnosed at older ages. Current glycaemic control, measured by HbA 1c , insulin requirements and use of a continuous glucose monitor were not different by age at diagnosis. Coeliac disease was the only comorbidity that was observed to have a different frequency by age at diagnosis, being more common in the participants diagnosed at a younger age. Conclusions These results show differences and similarities between type 1 diabetes diagnosed in childhood vs adulthood; notably, there was a tendency for there was a higher frequency of diabetic ketoacidosis at onset in children and a higher frequency of use of oral antidiabetes agents in adults. The data indicate that there is little distinction between the clinical characteristics and outcomes of type 1 diabetes diagnosed in childhood vs adulthood. Optimizing glycaemic control remains a challenge in all age groups, with lower use of insulin pumps impacting those diagnosed as adults.