Endocrine Abstracts

Background: There is an increased incidence of Type 1 diabetes in preschool children and the management of diabetes in this group is challenging. Preschool children are dependent on others for all aspects of their care. Normoglycaemia in preschool children reduces the likelihood of acute and chronic complications.

Objectives: Our goals were to:

1. Outline the demographic characteristics of children diagnosed with diabetes before 5 years of age.

2. Compare HbA1C levels at diagnosis, one and two years of diagnosis.

3. Outline the clinical mode of presentation of diabetes in this age group.

4. Review diabetes auto-antibodies profile in this group.

5. Benefits of early initiation of insulin pump therapy in this age group.

Methods: We studied 75 children under 5 years with Type 1 diabetes diagnosed between January 2009 and December 2017. Patients’ data were collected from local diabetes database, medical notes, and electronic notes.

Results: The median age was 3.1 years at diagnosis and 41% were boys. Caucasians represented 74% followed by Asian 21%. 28 (37%) children presented in diabetic ketoacidosis (DKA). 66 children had diabetic antibodies checked with GAD being the commonest (60%) followed by IA2 (55%) and Islet cell antibodies (33%). 58 out of 67 children had 1 or more positive antibodies. Insulin pump therapy is used presently by 51 (68%) children.

Conclusions: Over one-third of children in our study presented in DKA. Median HbA1c levels improved at 1 year and 2 years since diagnosis and the best improvement was in the group started on insulin pump within 1 year of diagnosis. Table comparing HbA1c levels at diagnosis, 1 year and 2 years.