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J Diabetes Complications. 2012 May-Jun;26(3):219-24. doi: 10.1016/j.jdiacomp.2012.03.016. Epub 2012 Apr 18.

Retrospective comparative analysis of metabolic control and early complications in familial and sporadic type 1 diabetes patients.

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  • 1The 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.

Abstract

BACKGROUND:

Genetic susceptibility and lifestyle are associated with glycemic control and diabetic complications in type 1 diabetes (T1D).

OBJECTIVES:

To investigate metabolic control and occurrence of acute and microvascular complications among familial and sporadic T1D patients.

PATIENTS AND 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.

Copyright © 2012 Elsevier Inc. All rights reserved.

PMID:
22520402
[PubMed - indexed for MEDLINE]
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