Characteristics of adult- compared to childhood-onset type 1 diabetes.


Journal

Diabetic medicine : a journal of the British Diabetic Association
ISSN: 1464-5491
Titre abrégé: Diabet Med
Pays: England
ID NLM: 8500858

Informations de publication

Date de publication:
12 2020
Historique:
accepted: 27 04 2020
pubmed: 1 5 2020
medline: 30 10 2021
entrez: 1 5 2020
Statut: ppublish

Résumé

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. 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. 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 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.

Identifiants

pubmed: 32353892
doi: 10.1111/dme.14314
doi:

Substances chimiques

Cholesterol, HDL 0
Cholesterol, LDL 0
Glycated Hemoglobin A 0
Hypoglycemic Agents 0
Insulin 0
Triglycerides 0
hemoglobin A1c protein, human 0

Types de publication

Comparative Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2109-2115

Subventions

Organisme : Leona M. and Harry B. Helmsley Charitable Trust
Pays : International

Informations de copyright

© 2020 Diabetes UK.

Références

Rogers MAM, Kim C, Banerjee T, Lee JM. Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: a longitudinal study. BMC Med 2017; 15: 199.
American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020; 43: S14-S31.
Centre NCG. Type 1 Diabetes in Adults: Diagnosis and Management. London: National Institute for Health and Care; 2015.
Hawa MI, Kolb H, Schloot N, Beyan H, Paschou SA, Buzzetti R et al. Adult-onset autoimmune diabetes in Europe is prevalent with a broad clinical phenotype: Action LADA 7. Diabetes Care 2013; 36: 908-913.
Thomas NJ, Lynam AL, Hill AV, Weedon MN, Shields BM, Oram RA et al. Type 1 diabetes defined by severe insulin deficiency occurs after 30 years of age and is commonly treated as type 2 diabetes. Diabetologia 2019; 62: 1167-1172.
Beck RW, Tamborlane WV, Bergenstal RM, Miller KM, Dubose SN, Hall CA. The T1D Exchange Clinic Registry. J Clin Endocrinol Metab 2012; 97: 4383-4389.
Miller KM, Foster NC, Beck RW, Bergenstal RM, DuBose SN, DiMeglio LA et al. Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry. Diabetes Care 2015; 38: 971-978.
Miller KM, Xing D, Tamborlane WV, Bergenstal RM, Beck RW. Challenges and future directions of the T1D Exchange Clinic Network and registry. J Diabetes Sci Technol 2013; 7: 963-969.
Bravis V, Kaur A, Walkey HC, Godsland IF, Misra S, Bingley PJ et al. Relationship between islet autoantibody status and the clinical characteristics of children and adults with incident type 1 diabetes in a UK cohort. BMJ Open 2018; 8: e020904.
Pilla SJ, Balasubramanyam A, Knowler WC, Lazo M, Nathan DM, Pi-Sunyer X et al. Islet autoantibody positivity in overweight and obese adults with type 2 diabetes. Autoimmunity 2018; 51: 408-416.
Davis AK, DuBose SN, Haller MJ, Miller KM, DiMeglio LA, Bethin KE et al. Prevalence of detectable C-Peptide according to age at diagnosis and duration of type 1 diabetes. Diabetes Care 2015; 38: 476-481.

Auteurs

A Casu (A)

AdventHealth, Translational Research Institute, Orlando, FL, USA.

L G Kanapka (LG)

Jaeb Centre for Health Research, Tampa, FL, USA.

N C Foster (NC)

Jaeb Centre for Health Research, Tampa, FL, USA.

I B Hirsch (IB)

University of Washington, Seattle, WA, USA.

L M Laffel (LM)

Joslin Diabetes Centre, Harvard Medical School, Boston, MA, USA.

V N Shah (VN)

Barbara Davis Centre for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

D J DeSalvo (DJ)

Baylor College of Medicine, Houston, TX, USA.

S K Lyons (SK)

Baylor College of Medicine, Houston, TX, USA.

F Vendrame (F)

University of Miami, Miami, FL, USA.

G Aleppo (G)

Northwestern University, Chicago, IL, USA.

L D Mastrandrea (LD)

University at Buffalo, Jacobs School of Medicine, Buffalo, NY, USA.

R E Pratley (RE)

AdventHealth, Translational Research Institute, Orlando, FL, USA.

M R Rickels (MR)

Rodebaugh Diabetes Centre, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

A L Peters (AL)

Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

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