Characteristics of childhood and adult-onset type 1 diabetes in a multi-ethnic population.
OBJECTIVE
To compare patients with classic type 1 diabetes (T1D) diagnosed in childhood and adulthood regarding clinical presentation, GADA and HLA DR B1*03/04 prevalence in a multi-ethnic population.


METHODS
We studied 83 Brazilian patients with classic T1D divided in 2 groups: (1) diagnosed before 20 years old (n=42); (2) diagnosed at age 20 and up (n=41). All were interviewed and blood was sampled for GADA measurement and HLA DR B1 typing.


RESULTS
The study population comprised 52 women and 31 men, 52 white and 31 non-white individuals with mean age of 29.94 (+/-10.95) years and mean disease duration of 10.37 (+/-7.37) years. The mean age at onset in groups 1 and 2 were, respectively, 11.48 and 27.2 years old. There were no significant differences between groups regarding diabetic ketoacidosis at presentation. A longer symptomatic period preceding the diagnosis was observed in group 2 (p=0.039). The prevalence of GADA and HLA DR B1*03/04 was similar between groups. HLA DR B1*13 was significantly more common in the group 1 (p=0.024). GADA was more prevalent among patients with HLA DR B1*03 (p=0.02).


CONCLUSIONS
In this study, T1D diagnosed in adulthood was associated with longer symptomatic period preceding diagnosis and lower prevalence of HLA DR B1*13, but there were no differences regarding ketoacidosis as a form of disease presentation, GADA (+) or HLA DR B1* 03/04.
Rodacki
Melanie
M
Diabetes and Immunology Sections, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. melanie.rodacki@joslin.harvard.edu
Zajdenverg
Lenita
L
Tortora
Rosangela Prendin
RP
Reis
Fabiola Aarao
FA
Albernaz
Martha S
MS
Goncalves
Maria Rocio Bencke
MR
Milech
Adolpho
A
de Oliveira
Jose Egidio Paulo
JE
D000328:Adult; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics / Q000276:immunology / Q000503:physiopathology*; D005006:Ethnicity; D005190:Family; D005260:Female; D006684:HLA-DR Antigens / Q000235:genetics; D059811:HLA-DRB1 Chains; D006801:Humans; D007330:Insulin Antibodies / Q000097:blood; D008297:Male
D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; D007330:Insulin Antibodies