Journal of Pediatric Endocrinology and Metabolism
Editor-in-Chief: Kiess, Wieland
Ed. by Bereket, Abdullah / Cohen, Pinhas / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Feihong / Mericq, Veronica / Toppari, Jorma
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Glycemic control in familial vs. sporadic type 1 diabetes patients over 5 years
1Division of Endocrinology and Metabolism, Department of Pediatrics, Rhode Island Hospital and Hasbro Children’s Hospital/The Warren Alpert Medical School of Brown University, Providence, RI, USA
2Information Services Department, Lifespan Corp., Providence, RI, USA
3Division of Adult Endocrinology, Department of Internal Medicine, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, RI, USA
4Department of Child and Adolescent Psychiatry, Rhode Island Hospital and Hasbro Children’s Hospital/The Warren Alpert Medical School of Brown University, Providence, RI, USA
Citation Information: Journal of Pediatric Endocrinology and Metabolism. Volume 27, Issue 1-2, Pages 31–35, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2013-0037, August 2013
- Published Online:
Background: Studies have shown that familial type 1 diabetes patients (FTID) have less severe metabolic derangement at presentation compared to sporadic patients (ST1D), but data on long-term metabolic control are lacking.
Objective/Hypothesis: (1) FT1D will have less severe presentation and better HbA1c over 5 years compared to ST1D; (2) HbA1c in the offspring will correlate with parent HbA1c in parent-offspring group; and (3) HbA1c of the second affected sibling (SP2) will correlate with the first affected sibling (SP1) in sib-pairs.
Methods: Cohort of 33 parent-offspring and 19 sib-pairs; controls included 33 sporadic subjects matched by age, sex, ethnicity, puberty, and insulin regimen. Paired t-test and Pearson’s correlation were used for statistical analysis.
Results: At diagnosis, mean age in FT1D vs. matched ST1D (7.7±4.9 vs. 7.6±4.5 years), mean HbA1c (9.6% vs. 10.7%), HCO3 (21 vs. 18 meq/L), glucose (428 vs. 463 mg/dL) and pH (7.35 vs. 7.36; p=ns) were not different. At 5 years, HbA1c (8.9% vs. 8.8%; p=0.81), clinic visits (12 vs. 12.5, p=0.68) and emergency room visits (0.48 vs. 0.24, p=0.10) were not different. In affected siblings, only HCO3 was different (SP1:18 vs. SP2: 24 meq/L; p<0.01). HbA1c for SP2 correlated positively with SP1 (r=0.67, p<0.01). Offspring HbA1c correlated positively with affected parents (9.3% vs. 8.6%, r=0.57, p=0.18) but was not significant.
Conclusion: Metabolic control at diagnosis and at 5 years was similar in FT1D and ST1D. In sib-pairs, the second affected sibling had milder clinical presentation compared to the first affected sibling.