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Clinical characteristics of type 1 diabetes over a 40 year period in Turkey: secular trend towards earlier age of onset

  • Didem Ardicli EMAIL logo , Nurgun Kandemir , Ayfer Alikasifoglu , Alev Ozon and Nazli Gonc
Published/Copyright: March 29, 2014
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 27 Issue 7-8

Abstract

Objective: To determine the demographic and clinical characteristics of type 1 diabetes (T1D) in the past two decades, and to analyze changing trends over the past 40 years.

Methods: Patients with a diagnosis of T1D in 1990–2010 were included. Patients diagnosed in the first half of the period comprised Period I, and those from the second half comprised Period II. Age at onset, gender, seasonal distribution, infectious etiology, and clinical picture at onset are analyzed and compared in two periods. In addition, we compared these data with that of the preceding two decades (1969–1991), which was reported in a previous publication.

Results: A total of 354 children with T1D were included in the study. The median age at diagnosis of T1D was 7 years in the period 1990–2010 in comparison to 9.5 years during the period 1969–1991. Patients were diagnosed mostly in winter and autumn, and 32.3% of the children had an infection at the time of diagnosis. Frequency of diabetic ketoacidosis was 50.8% at diagnosis. The peak age at onset was 4 to 6 years.

Conclusions: Our study provides substantial information about the clinical characteristics of Turkish children. The age of onset of T1D decreased in the past 20 years, as observed in other parts of the world. Our findings also suggest seasonality at onset of T1D. This study shows the changes of demographic and clinical characteristics of T1D in central and northeastern parts of our country over a 40 year period.

Keywords: childhood; Turkey; type 1 diabetes mellitus
Corresponding author: Didem Ardicli, MD, Department of Pediatric Endocrinology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey, Phone/fax: +90-3123051124, E-mail:

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Received: 2013-8-2
Accepted: 2014-2-21
Published Online: 2014-3-29
Published in Print: 2014-7-1

©2014 by Walter de Gruyter Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Welcome to Assistant Editors at JPEM
  4. Review article
  5. Common approach to childhood obesity in Japan
  6. Images in pediatric endocrinology
  7. Aromatase deficiency in an adolescent girl misdiagnosed as congenital adrenal hyperplasia in infancy and childhood
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  10. Analysis of body composition among children and adolescents – a cross-sectional study of the Polish population and comparison of body fat measurement methods
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  12. Differences in anxiety and depression between male and female caregivers of children with a disorder of sex development
  13. Fasting and postprandial levels of a novel anorexigenic peptide nesfatin in childhood obesity
  14. The effect of growth hormone treatment on height in children with idiopathic short stature
  15. Clinical characteristics of type 1 diabetes over a 40 year period in Turkey: secular trend towards earlier age of onset
  16. Relationships of gamma-glutamyltransferase and beta 2-microglobulin on high sensitivity C-reactive protein among Japanese elementary school children
  17. Evaluation of insulin resistance and metabolic syndrome in a group of obese Czech children
  18. Circulating intact parathyroid hormone is suppressed at 25-hydroxyvitamin D concentrations >25 nmol/L in children
  19. Association between vitamin D level and cardiovascular risk in obese children and adolescents
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  21. Clinical features at diagnosis and responses to antithyroid drugs in younger children with Graves’ disease compared with adolescent patients
  22. Influence of hormonal parameters, bone mineral density and bone turnover on fracture risk in healthy male adolescents: a case control study
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  27. Outcome analysis of aromatase inhibitor therapy to increase adult height in males with predicted short adult stature and/or rapid pubertal progress: a retrospective chart review
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  32. Atypical neurologic presentations of new onset type 1 diabetes mellitus in pediatric age group: a report of five unusual cases and review of the literature
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  34. Vitamin D intoxication in two brothers: be careful with dietary supplements
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  37. Holoprosencephaly: ZIC2 mutation in a case with panhypopituitarism
  38. An association of hypochondroplasia and immune deficiency
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https://doi.org/10.1515/jpem-2013-0320
Keywords for this article
childhood; Turkey; type 1 diabetes mellitus

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Welcome to Assistant Editors at JPEM
  4. Review article
  5. Common approach to childhood obesity in Japan
  6. Images in pediatric endocrinology
  7. Aromatase deficiency in an adolescent girl misdiagnosed as congenital adrenal hyperplasia in infancy and childhood
  8. Original articles
  9. Prevalence of vitamin D deficiency among Iranian adolescents
  10. Analysis of body composition among children and adolescents – a cross-sectional study of the Polish population and comparison of body fat measurement methods
  11. Association of rs8066560 variant in the sterol regulatory element-binding protein 1 (SREBP-1) and miR-33b genes with hyperglycemia and insulin resistance
  12. Differences in anxiety and depression between male and female caregivers of children with a disorder of sex development
  13. Fasting and postprandial levels of a novel anorexigenic peptide nesfatin in childhood obesity
  14. The effect of growth hormone treatment on height in children with idiopathic short stature
  15. Clinical characteristics of type 1 diabetes over a 40 year period in Turkey: secular trend towards earlier age of onset
  16. Relationships of gamma-glutamyltransferase and beta 2-microglobulin on high sensitivity C-reactive protein among Japanese elementary school children
  17. Evaluation of insulin resistance and metabolic syndrome in a group of obese Czech children
  18. Circulating intact parathyroid hormone is suppressed at 25-hydroxyvitamin D concentrations >25 nmol/L in children
  19. Association between vitamin D level and cardiovascular risk in obese children and adolescents
  20. Serum paraoxonase activity and oxidative stress and their relationship with obesity-related metabolic syndrome and non-alcoholic fatty liver disease in obese children and adolescents
  21. Clinical features at diagnosis and responses to antithyroid drugs in younger children with Graves’ disease compared with adolescent patients
  22. Influence of hormonal parameters, bone mineral density and bone turnover on fracture risk in healthy male adolescents: a case control study
  23. Evaluation of lipid and glucose metabolism and cortisol and thyroid hormone levels in obese appropriate for gestational age (AGA) born and non-obese small for gestational age (SGA) born prepubertal Slovak children
  24. Chitotriosidase as a possible marker of clinically evidenced atherosclerosis in dyslipidemic children
  25. Exhaled carbon monoxide in adolescents with diabetic cardiovascular autonomic neuropathy
  26. Gut hormone profiles in preterm and term infants during the first 2 months of life
  27. Outcome analysis of aromatase inhibitor therapy to increase adult height in males with predicted short adult stature and/or rapid pubertal progress: a retrospective chart review
  28. A deletion including exon 2 of the TSHR gene is associated with thyroid dysgenesis and severe congenital hypothyroidism
  29. Steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) in childhood
  30. Patient Reports
  31. Neonatal diabetes in an infant of diabetic mother: same novel INS missense mutation in the mother and her offspring
  32. Atypical neurologic presentations of new onset type 1 diabetes mellitus in pediatric age group: a report of five unusual cases and review of the literature
  33. Importance of dietary calcium and vitamin D in the treatment of hypercalcaemia in Williams-Beuren syndrome
  34. Vitamin D intoxication in two brothers: be careful with dietary supplements
  35. Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing
  36. A rare case of hypoglycaemia due to insulinoma in an adolescent with acutely altered mental status
  37. Holoprosencephaly: ZIC2 mutation in a case with panhypopituitarism
  38. An association of hypochondroplasia and immune deficiency
  39. Hypophosphatemic rickets caused by a novel PHEX gene mutation in an Indian girl
  40. Psoriasis vulgaris and autoimmune polyendocrine syndrome type I: a case report
  41. Identification of a combined missense/splice-site mutation in FAH causing tyrosinemia type 1
  42. Letter to the Editor
  43. Vitamin D intake and premature infants with intraventricular hemorrhage: how advisable is it?
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