Clinical Characteristics and Associated Comorbidities in Children and Adolescents With Type 1 Diabetes Mellitus: A...

Type 1 diabetes mellitus (T1DM) in pediatric and adolescent populations is correlated with significant metabolic instability and an elevated risk of autoimmune and metabolic comorbidities, which can negatively impact long-term health outcomes. Notwithstanding the increasing prevalence of pediatric T1DM in Saudi Arabia, there is a paucity of region-specific evidence delineating the clinical profiles and associated comorbid conditions within this demographic. This study aimed to evaluate the clinical features and comorbidities among children and adolescents with T1DM.

This retrospective analysis was conducted from March 2020 to February 2023 at the Pediatrics Department of King Saud Hospital in Unaizah, Qassim region, Saudi Arabia. The study included Saudi children aged two to 17 years diagnosed with T1DM. Sociodemographic, anthropometric, and laboratory data were extracted. Data were analyzed using SPSS v22 (IBM Corp., Armonk, NY, USA). Descriptive statistics were used, along with paired-samples t-tests to assess changes in glycated hemoglobin (HbA1c) and chi-square tests to examine associations between variables.

This study included 407 children and adolescents with T1DM. There were 211 males (51.8%) and 196 females (48.2%). The mean age was 12.27±4.54 years, with a mean age at diagnosis of 7.92±3.94 years. Poor glycemic control at diagnosis (HbA1c ≥ 9%) was observed in 288/370 patients (77.8%), which decreased to 222/375 patients (59.2%) at final follow-up, with a mean HbA1c reduction of 0.83%. A family history of T1DM was noted in 50/131 patients (38.2%), and type 2 diabetes in 83/121 patients (68.6%). The prevalence of poor glycemic control (HbA1c ≥9%) differed significantly across age groups, with higher rates observed among adolescents aged 10-15 years (67.6%) and ≥15 years (64.9%) compared with children aged <10 years (36.3%) (p<0.001).

Children and adolescents with T1DM were found to have poor glycemic control and a high rate of autoimmune and metabolic comorbidities, particularly thyroid dysfunction, dyslipidemia, and vitamin D deficiency. These findings highlight the need for systematic screening and comprehensive clinical monitoring in pediatric populations with T1DM.