Diabetic autoimmunity in infants and pre-schoolers with type 1 diabetes

E H Hathout1, J Sharkey, M Racine

  • 1Pediatric Diabetes Center, Loma Linda University Children's Hospital, Loma Linda, CA 92354, USA. hathout@aol.com

Pediatric Diabetes
|March 16, 2004
PubMed

Insights

Type 1 diabetes is rapidly increasing in young children, presenting with more severe symptoms like diabetic ketoacidosis. Early-onset type 1 diabetes shows fewer autoimmune markers, suggesting potential age-related differences in disease development.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Immunology

Background:

  • Type 1 diabetes (T1D) incidence is rising fastest in children under 5.
  • Early-onset T1D may be more aggressive and less understood than traditional T1D.
  • Limited data exists on the demographics and autoimmune markers in very young T1D patients.

Purpose of the Study:

  • To analyze demographic, clinical, and autoimmune characteristics of T1D in children under 5.
  • To compare early-onset T1D (diagnosed <5 years) with later-onset T1D (diagnosed >5 years).
  • To investigate potential age-related differences in T1D pathogenesis.

Main Methods:

  • Retrospective analysis of 47 children diagnosed with T1D before age 5.
  • Comparison with a cohort of 49 children diagnosed after age 5.
  • Measurement of islet-cell antibodies (ICAs), GAD65, and insulin autoantibodies (IAAs).

Main Results:

  • Children with early-onset T1D had higher rates of viral illness symptoms and diabetic ketoacidosis (DKA) at diagnosis.
  • Later-onset T1D patients had higher hemoglobin A1c (HbA1c) levels at diagnosis.
  • Early-onset T1D showed significantly lower positivity for ICAs and GAD antibodies compared to later-onset T1D.

Conclusions:

  • Infants and toddlers with new-onset T1D exhibit fewer diabetes immune markers.
  • The accelerated disease course and lower HbA1c in early-onset T1D may indicate age-specific autoimmune responses.
  • Non-autoimmune diabetogenic mechanisms could contribute to T1D in very young children.

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