title: Diabetes care, glycemic control, complications, and concomitant autoimmune diseases in children with type 1 diabetes in Turkey: a multicenter study.
abstract: OBJECTIVE
  Epidemiologic and clinical features of type 1 diabetes mellitus (T1DM) may show substantial differences among countries. The primary goal in the management of T1DM is to prevent micro- and macrovascular complications by achieving good glycemic control. The present study aimed to assess metabolic control, presence of concomitant autoimmune diseases, and of acute and long-term complications in patients diagnosed with T1DM during childhood and adolescence. The study also aimed to be a first step in the development of a national registry system for T1DM, in Turkey.
  
  
  METHODS
  Based on hospital records, this cross-sectional, multicenter study included 1 032 patients with T1DM from 12 different centers in Turkey, in whom the diagnosis was established during childhood. Epidemiological and clinical characteristics of the patients were recorded. Metabolic control, diabetes care, complications, and concomitant autoimmune diseases were evaluated.
  
  
  RESULTS
  Mean age, diabetes duration, and hemoglobin A1c level were 12.5 ± 4.1 years, 4.7 ± 3.2 years, and 8.5 ± 1.6%, respectively. Acute complications noted in the past year included ketoacidosis in 5.2% of the patients and severe hypoglycemia in 4.9%. Chronic lymphocytic thyroiditis was noted in 12%, Graves' disease in 0.1%, and celiac disease in 4.3% of the patients. Chronic complications including neuropathy, retinopathy, and persistent microalbuminuria were present in 2.6%, 1.4%, and 5.4% of the patients, respectively. Diabetic nephropathy was not present in any of the patients. Mean diabetes duration and age of patients with neuropathy, retinopathy and microalbuminuria were significantly different from the patients without these long-term complications (p<0.01). A significant difference was found between pubertal and prepubertal children in terms of persistent microalbuminuria and neuropathy (p=0.02 and p<0.001, respectively). Of the patients, 4.4% (n:38) were obese and 5% had short stature; 17.4% of the patients had dyslipidemia, and 14% of the dyslipidemic patients were obese.
  
  
  CONCLUSIONS
  Although the majority of the patients in the present study were using insulin analogues, poor glycemic control was common, and chronic complications were encountered.
authors: Ege University, School of Medicine, Department of Pediatric Endocrinology, Izmir, Turkey. damla.goksen@ege.edu.tr
authors: Damla Gökşen
authors: DG
authors: Simsek
authors: Zehra
authors: Z
authors: Aycan
authors: Samim
authors: S
authors: Özen
authors: Semra
authors: S
authors: Cetinkaya
authors: Cengiz
authors: C
authors: Kara
authors: Saygın
authors: S
authors: Abalı
authors: Korcan
authors: K
authors: Demir
authors: Ozgül
authors: O
authors: Tunç
authors: Ahmet
authors: A
authors: Uçaktürk
authors: Gülgün
authors: G
authors: Asar
authors: Firdevs
authors: F
authors: Baş
authors: Ergun
authors: E
authors: Cetinkaya
authors: Murat
authors: M
authors: Aydın
authors: Gülay
authors: G
authors: Karagüzel
authors: Zerrin
authors: Z
authors: Orbak
authors: Zeynep
authors: Z
authors: Sıklar
authors: Ayça
authors: A
authors: Altıncık
authors: Ayşenur
authors: A
authors: Ökten
authors: Behzat
authors: B
authors: Özkan
authors: Gönül
authors: G
authors: Ocal
authors: Serap
authors: S
authors: Semiz
authors: İlknur
authors: İ
authors: Arslanoğlu
authors: Olcay
authors: O
authors: Evliyaoğlu
authors: Rüveyde
authors: R
authors: Bundak
authors: Şükran
authors: Ş
authors: Darcan
mesh_terms: D000293:Adolescent; D001327:Autoimmune Diseases / Q000150:complications*; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007223:Infant; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D009765:Obesity / Q000150:complications; D014421:Turkey; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin