Clinical features at the onset of childhood type 1 diabetes mellitus in Shenyang, China.
OBJECTIVE
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.


CONCLUSIONS
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.
Xin
Ying
Y
Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China. xin.ying168@live.cn
Yang
Min
M
Chen
Xiao Juan
XJ
Tong
Ya Jie
YJ
Zhang
Li Hua
LH
D000293:Adolescent; D017668:Age of Onset; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D002681:China; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011141:Polyuria / Q000209:etiology; D012189:Retrospective Studies; D015431:Weight Loss