title: Retrospective comparative analysis of metabolic control and early complications in familial and sporadic type 1 diabetes patients.
abstract: BACKGROUND
  Genetic susceptibility and lifestyle are associated with glycemic control and diabetic complications in type 1 diabetes (T1D).
  
  
  OBJECTIVE
  To investigate metabolic control and occurrence of acute and microvascular complications among familial and sporadic T1D patients.
  
  
  METHODS
  Retrieved from our institutional registry of new T1D cases for the years 1979-2008 were 226 familial patients belonging to 121 families (58 parent-offspring, 63 sib-pairs) and 226 sporadic cases matched for age, gender, and year of diagnosis. Extracted from medical files were clinical course and therapeutic regimen.
  
  
  RESULTS
  Mean age at diagnosis of diabetes of the cohort was 10.8 ± 5.7 years. Throughout follow-up (11.1 ± 8.7 years) mean HbA1c values were significantly higher in familial than in sporadic cases (8.18%± 1.15% vs. 7.85%± 1.15%, p=0.005). Diabetic ketoacidosis (DKA) rates were higher in familial than sporadic cases (2.8 vs. 1.9 events per 100 patient-years; incidence rate ratio (IRR)=1.5, 95% CI [1.03, 2.22, p=0.03]). Severe hypoglycemia events per 100 patient-years were comparable in familial and sporadic groups (3.7 vs. 4.0 events); sib-pairs had higher rates than parent-offspring (4.8 vs. 2.4 events; (IRR)=2, 95% CI [1.03, 3.25, p=0.03]). The percentage of patients with microvascular complications was similar in the familial (21.7%) and sporadic (26.7%) groups. In both familial and sporadic cases the most significant predictor for metabolic control and microvascular complications was diabetes duration; a higher mean HbA1c level was the predictor for DKA events.
  
  
  CONCLUSIONS
  The worse metabolic control and increased rate of DKA in familial T1D patients as compared to those in the sporadic T1D patients warrant intensified surveillance in this population.
authors.affiliation: The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel (SCMCI), Petach Tikva 49202.
authors.forename: Yael
authors.initials: Y
authors.lastname: Lebenthal
authors.forename: Shlomit
authors.initials: S
authors.lastname: Shalitin
authors.forename: Michal
authors.initials: M
authors.lastname: Yackobovitch-Gavan
authors.forename: Moshe
authors.initials: M
authors.lastname: Phillip
authors.forename: Liora
authors.initials: L
authors.lastname: Lazar
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000378:metabolism / Q000628:therapy*; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D001786:Blood Glucose