Clinical Presentation and Autoimmune Characteristics of Very Young Children at the Onset of Type 1 Diabetes Mellitus

The aim of our study was to identify factors that are related to a more aggressive beta-cell destruction in children at presentation of type 1 diabetes mellitus (T1D). We analyzed age, HbAlc, pH, bicarbonate, IAA, IA2, GADA, C peptide of 290 consecutive patients with T1D at onset. Seventy-three (25.2%) were younger than 4 years; 217 (74.8%) were aged 4-18 years. Younger patients had lower C peptide, pH and bicarbonate than older ones. Age at T1D onset was negatively related to IAA titers (r: -0.3404, p < 0.001), positively related to IA2 titers (r: 0.1249, p: 0.03) and to C peptide (r: 0.42, p: < 0.001). Multivariable linear regression showed that C peptide was negatively related to HbA1c and positively related to age, pH at admission and IAA titers. T1D in very young children is characterized by a more extensive beta-cell destruction, and younger age at onset is related to a more severe decompensation.