title: Clinical characteristics of type 1 diabetes mellitus in Taiwanese children aged younger than 6 years: A single-center experience.
abstract: OBJECTIVE
  Cases of type 1 diabetes mellitus in children aged younger than 6 years in Taiwan has increased in the past 10 years. This retrospective study aimed to review the management experience of such patients in a single center.
  
  
  METHODS
  From January 2004 to June 2015, 52 newly diagnosed diabetic children younger than 6 years who had regular follow-up for > 1 year were enrolled, as well as 94 older diabetic children for comparison. Their medical records were thoroughly reviewed.
  
  
  RESULTS
  The most common symptoms and signs were polyuria, polydipsia, dry lips, weight loss, and nocturia. Among the children younger than 6 years, 87% had ketoacidosis upon diagnosis-significantly higher than that of the older age group-and 88% had at least one islet cell autoantibody detected. Their serum C-peptide levels were significantly lower and the frequency of insulin autoantibodies detected was significantly higher compared with the older age group (37% vs. 10%). The remission rate of the young diabetic patients was significantly lower than that of the older age group (40% vs. 59%), but there was no difference in time of onset and duration of remission between the two groups.
  
  
  CONCLUSIONS
  Autoimmune destruction of pancreatic β-cells is an important cause of type 1 diabetes mellitus in Taiwanese children aged younger than 6 years. These patients usually have a low insulin reserve and severe ketoacidosis upon diagnosis. A high index of suspicion in the presence of classic symptoms of diabetes in young children is important to prevent complications.
authors: Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Yi-Chen
authors: YC
authors: Chen
authors: Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Yi-Ching
authors: YC
authors: Tung
authors: Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Shih-Yao
authors: SY
authors: Liu
authors: Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Cheng-Ting
authors: CT
authors: Lee
authors: Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: wenyutsai@ntu.edu.tw.
authors: Wen-Yu
authors: WY
authors: Tsai
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001323:Autoantibodies / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000473:pathology*; D016883:Diabetic Ketoacidosis / Q000209:etiology; D005260:Female; D006801:Humans; D008046:Lip / Q000473:pathology; D008297:Male; D053158:Nocturia / Q000209:etiology; D059606:Polydipsia / Q000209:etiology; D011141:Polyuria / Q000209:etiology; D063189:Symptom Assessment; D013624:Taiwan; D015431:Weight Loss
chemical_list: D001323:Autoantibodies; D001786:Blood Glucose; D002096:C-Peptide; C024211:islet cell antibody
keywords: C-peptide; autoantibodies; ketoacidosis; remission; type 1 diabetes mellitus