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Clinical features at the onset of childhood type 1 diabetes mellitus in Shenyang, China
Author(s) -
Xin Ying,
Yang Min,
Chen Xiao Juan,
Tong Ya Jie,
Zhang Li Hua
Publication year - 2010
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2009.01657.x
Subject(s) - medicine , polyuria , diabetic ketoacidosis , polydipsia , incidence (geometry) , diabetes mellitus , pediatrics , ketoacidosis , type 1 diabetes , age of onset , endocrinology , physics , disease , optics
Aim: To describe the clinical picture and laboratory features of Chinese children with newly diagnosed type 1 diabetes mellitus. Methods: The clinical and laboratory data of a total of 203 children who presented with newly diagnosed type 1 diabetes mellitus during a 5‐year period (2004–2008) were retrospectively analysed based on hospital records. Results: There were 88 boys (43.3%) and 115 girls (56.7%) with a median age of 8.3 years. The age distribution was categorised as 0–4 years: 52 (25.6%), 5–9 years: 57 (28.1%) and 10–14 years: 94 (46.3%). We found a peak incidence rate in the older age group. No significant seasonality was observed. The most common symptoms were polydipsia, polyuria and weight loss. Eighty‐five (41.9%) of all patients presented with diabetic ketoacidosis (DKA). The average duration of presenting symptoms before the hospital encounter was 24.5 days. Young age group children had shorter duration (17.1 days, P = 0.03) and significantly lower levels of C‐peptide ( P = 0.003) and haemoglobin A1c ( P = 0.049) than the other groups. Children with DKA had a higher incidence of preceding infections ( P = 0.032), lower free triiodothyronine and free thyroxine levels ( P = 0.035, 0.046), and higher white blood cell counts ( P = 0.000) than the non‐DKA group. Conclusion: The duration between the onset of the symptoms and diagnosis was long, and the proportion of DKA in children with newly diagnosed diabetes mellitus was high. These findings call for a collaborative effort for the early recognition of symptoms by patients and physicians in order to avoid more severe types of presentation.