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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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  1. Home
  3. Age-related Heterogeneity Of Type 1 Diabetes Mellitus In Children: A Single-center Retrospective Study.
  1. Home
  3. Age-related Heterogeneity Of Type 1 Diabetes Mellitus In Children: A Single-center Retrospective Study.

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Age-related heterogeneity of type 1 diabetes mellitus in children: a single-center retrospective study.

Shi-Yang Gao1, Yi-Guo Huang1, Li-Bo Wang1

  • 1Department of Endocrinology, Metabolism and Genetics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, DongFang Road, PuDong District, Shanghai, 200127, China.

World Journal of Pediatrics : WJP
|December 27, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Type 1 diabetes shows varied features across age groups. Early-onset T1DM in children indicates poorer islet function, while later onset increases metabolic complication risks, necessitating age-specific care.

Keywords:
Age of onsetAutoimmunityChildrenIslet cell functionMetabolismType 1 diabetes mellitus

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Area of Science:

  • Pediatric Endocrinology
  • Immunology
  • Metabolic Disorders

Background:

  • Type 1 diabetes mellitus (T1DM) is an autoimmune disease with significant heterogeneity.
  • Understanding age- and ethnicity-related differences is crucial for effective T1DM management and precision medicine.
  • This study examines the clinical, metabolic, and immunological diversity of T1DM in children based on age at diagnosis.

Purpose of the Study:

  • To investigate the heterogeneity of Type 1 diabetes mellitus in pediatric patients.
  • To compare clinical, metabolic, and immunological characteristics across different age groups at diagnosis.
  • To inform the development of age-specific management strategies for T1DM.

Main Methods:

  • Retrospective analysis of 401 children newly diagnosed with T1DM.
  • Comparison of cohort characteristics with international data.
  • Categorization of patients into three age groups: 6 months-5 years, 5-10 years, and ≥10 years.
  • Analysis of clinical, metabolic (C-peptide AUC), and immunological markers (lymphocyte subsets, cytokines).

    • Main Results:

    • No significant differences in most clinical characteristics across age groups.
    • Younger children (6 months-5 years) exhibited lower C-peptide AUC, indicating reduced islet function.
    • Older children (≥10 years) showed higher rates of thyroid antibodies and vitamin D deficiency.
    • Immunological analysis revealed increased T and B lymphocytes, decreased IL-2, and increased IL-6 in T1DM patients compared to controls. The youngest group had a higher CD4/CD8 ratio correlated with C-peptide AUC.

    Conclusions:

    • Type 1 diabetes mellitus presents significant heterogeneity in clinical, metabolic, and immunological features among children based on age at onset.
    • Early-onset T1DM is associated with diminished islet function, while late-onset T1DM correlates with increased susceptibility to metabolic complications.
    • Age-specific management approaches are essential for optimizing outcomes in pediatric T1DM patients.