title: [Prevalence of autoimmune diseases and microangiopathy in children with diabetes type 1 over the years 2000-2010].
abstract: BACKGROUND
  In the past decade the number of patients with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) has increased rapidly. Treatment of the disease is focused on proper physical development and the prevention of complications. Aim of the study was to analyze changes in the treatment and clinical picture of type 1 diabetes in children over the years 2000 to 2010 with particular emphasis on the presence of autoimmune diseases and microangiopathy.
  
  
  METHODS
  The study included 567 children diagnosed with type 1 diabetes under the care of outpatient diabetes clinic. We compared 251 children, diabetes outpatient clinic patients in 2000, with 316 children in 2010. Data were obtained from the outpatient and hospital records. We compared baseline demographic, anthropometric data, treatment regimen, type of insulin, metabolic control, prevalence of autoimmune diseases and microangipathy.
  
  
  RESULTS
  In 2010 there was a reduction in the age of diagnosis of diabetes from 10 to 8 years (p=0.039). Significantly increased the proportion of children treated with CSII (up to 60.1%) and decreased the percentage of children using conventional insulin for the benefit of insulin analogs. The increase in HbA1c from 7.4 to 8.0% (p<0.001) has been shown and increase in proportion of patients with HbA1c >7.5% in 2010. The percentage of children with obesity increased from 5.2 to 13.7% (p=0.004) and there was a significant increase in SDS-BMI. The percentage of children with autoimmune diseases such as celiac (from 0,4 to 7,3%, p<0,001) and thyroid (from 6.9 to 21.3%, p<0.001) has increased. The incidence of retinopathy decreased from 6 to 1% (p=0.04), and albuminuria decreased insignificantly.
  
  
  CONCLUSIONS
  Over the last decade, a significant change in the method of treatment in children diagnosed with type 1 diabetes has occurred. The deterioration of metabolic control, despite the frequent use in the treatment of CSII, may be due to increased frequency of obesity and additional autoimmune diseases in today´s patients. More similar to physiologic way of insulin infusion in nowadays treatment may influence the decrease in the prevalence of retinopathy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Głowińska-Olszewska
authors.forename: Urszula
authors.initials: U
authors.lastname: Ordowska
authors.forename: Magdalena
authors.initials: M
authors.lastname: Golonko
authors.forename: Monika
authors.initials: M
authors.lastname: Tobiaszewska
authors.forename: Bożena
authors.initials: B
authors.lastname: Florys
authors.forename: Jolanta
authors.initials: J
authors.lastname: Jabłońska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Otocka
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Łuczyński
authors.forename: Aneta
authors.initials: A
authors.lastname: Zasim
authors.forename: Ewa
authors.initials: E
authors.lastname: Jakubowska
authors.forename: Justyna
authors.initials: J
authors.lastname: Michalak
authors.forename: Artur
authors.initials: A
authors.lastname: Bossowski
mesh_terms: D001327:Autoimmune Diseases / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000706:statistics & numerical data*; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male; D015995:Prevalence
chemical_list: D007328:Insulin