Akademik Veri Yönetim Sistemi
MEDICAL JOURNAL OF BAKIRKOY, cilt.19, sa.1, ss.22-30, 2023 (ESCI)
Objective: This study evaluated the findings of pediatric cases with diabetes mellitus (DM) who were admitted to a pediatric endocrinology unit for two years.Methods: In this retrospective, observational study, children and adolescents aged 0-18 years, were diagnosed with DM were evaluated. Cases were grouped as formerly diagnosed and new-onset. Demographic and laboratory features at admission were recorded. The type of diabetes was classified and, also the presence of diabetic ketoacidosis (DKA) and severe DKA was described according to the current criteria.Results: The mean age of 108 children (51 girls) at the time of the first evaluation in our unit was 10.3 +/- 4.4 (range 0.7-17.9) years. Seventy-eight children were diagnosed with diabetes (new-onset group) during the study period. The median age of the new-onset group was 11.2 years (IQR:6.3-13.1) The distribution of, type 1 diabetes (T1D), type 2 diabetes (T2D), and monogenic diabetes was 79.5% (n=62), 7.7% (n=6), and 12.8% (n=10), sincerely. The distribution of the types was similar in the formerly diagnosed group and the new-onset group (p=0.899). Sixty-two cases (28 girls) with new-onset T1D were evaluated. The mean age was 9.3 +/- 4.6 years (range 0.7-17.9) and, twenty-one percent of them (n=13) were under 5 years of age. The rate of DKA at the presentation was 41.9%. Severe acidosis (pH<7.1) ratio was 19.4%, and the percentage of cases with HCO3<5 mmol/L was 1.6%. Under 5 years of age, the ratio of acidosis and severe acidosis was higher than the cases older than 5 years (69.2% vs 34.7%, p=0.032 and 46.2% vs. 12.2%, p=0.013, sincerely).Conclusion: In our study, the rate of monogenic diabetes was found to be higher. In the widespread use of high-throughput genetic techniques era, the diagnosis will change to monogenic diabetes in antibody-negative children followed up with the diagnosis of type 1 diabetes. The rate of DKA has remained unchanged for 40 year; this fact indicates that striking and continuous programs targeting increased awareness of diabetes are needed.