Characteristics at diagnosis of type 1 diabetes in children younger than 6 years.
OBJECTIVE
To characterize the prodrome, presentation, family history, and biochemical status at diagnosis of type 1 diabetes mellitus (T1D) in children under age 6 years.


METHODS
This was a retrospective chart review of patients hospitalized at diagnosis with T1D from 1990 to 1999 in a children's hospital.


RESULTS
A total of 247 children were hospitalized, 44% of whom presented in diabetic ketoacidosis (DKA). When stratified by 2-year age intervals, only total carbon dioxide (tCO(2)) was significantly lower in the youngest children (P = .02), and the duration of candidiasis was significantly longer in those children presenting in DKA (P = .004). Parents were more likely to recognize symptomatic hyperglycemia in children older than 2 years (P < .0001). Most parents sought care for their child suspecting that the child had diabetes; the other children were diagnosed when presenting with another concern. Only gender and tCO(2) were significantly correlated with hemoglobin A1c (HbA1c); age-adjusted HbA1c was 0.64% higher in girls compared with boys (P = .045), and each 1-mmol/L decrement in tCO(2) increased the age- and gender-adjusted HbA1c by 0.086% (P < .001).


CONCLUSIONS
A high proportion of children under age 6 years present critically ill at the diagnosis of T1D. When any of the classic symptoms of diabetes or a yeast infection is present, a serum glucose level should be measured.
Quinn
Maryanne
M
Division of Endocrinology, Children's Hospital Boston, MA 02115, USA. Maryanne.Quinn@childrens.harvard.edu
Fleischman
Amy
A
Rosner
Bernard
B
Nigrin
Daniel J
DJ
Wolfsdorf
Joseph I
JI
D001786:Blood Glucose / Q000032:analysis; D001900:Boston / Q000453:epidemiology; D002177:Candidiasis / Q000453:epidemiology; D002245:Carbon Dioxide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000453:epidemiology; D016883:Diabetic Ketoacidosis / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010290:Parents; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D012189:Retrospective Studies; D012737:Sex Factors
D001786:Blood Glucose; D002245:Carbon Dioxide; D006442:Glycated Hemoglobin