Treatment of type 1 diabetes mellitus revealed below 7 years of age in the Diabetes Center of Silesia, Poland.

Introduction: Frequency of type 1 diabetes mellitus diagnosis in young children increases. Within this group, such factors as limited cooperation, little acceptance of multiple injections and other typical patterns of behavior can strongly influence the insulin management outcome.

Aim Of The Study: The objective of the study was to provide information regarding metabolic control in young diabetes patients.

Material And Methods: Charts of 58 children with T1DM, all subjects under control of our Department, that were aged at onset (1998-2003) below 7 years (mean 4.05+/-1.6) were studied retrospectively. HbA1c, total, bolus and basal daily insulin requirement (DIR), weight, height, severe hypoglycaemia and diabetic ketoacidosis (DKA) were analyzed till April 2006 in 2-year intervals. Insulin therapy model was also taken into consideration.

Results: Mean HbA1c was 7.2+/-1.2% for all children for the whole studied period and did not alter significantly between analyzed intervals. Most common treatment model at diabetes onset was the therapy with premixed insulin (Mix) (67%) and after 4 and 6 years - continuous subcutaneous insulin infusion (CSII) (50% and 75% respectively). A tendency for a better metabolic control was observed at multiple daily injections and CSII than at Mix. Change of the weight or height percentile channel was not revealed. Bolus and basal DIR increased in the first observation interval. Afterwards they stabilized respectively at 0.35-0.42 U/kg/24 h and 0.35-0.39 U/kg/24 h. Severe hypoglycaemia occurred 6.72/100 patient-years.

Conclusion: Insulin therapy aimed at maintaining long-term good metabolic control is possible to achieve and is safe in young diabetic children.