Infant and toddler type 1 diabetes: Complications after 20 years' duration

Silvana Salardi, Massimo Porta, Giulio Maltoni, Flavia Rubbi, Silvia Rovere, Franco Cerutti, Dario Iafusco, Stefano Tumini, Vittoria Cauvin, Francesco Cadario, Giuseppe D'Annunzio, Alessandro Salvatoni, Riccardo Schiaffini, Sonia Toni, Maria Antonietta Zedda, Stefano Zucchini

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

OBJECTIVE - To compare the effect of the prepubertal duration of diabetes on the occurrence of complications in two groups of patients after the same number of years of the disease. RESEARCH DESIGN AND METHODS - This multicenter study enrolled 105 patients aged 16-40.3 years; 53 were prepubertal at diagnosis (aged 0-3) and 52 were pubertal (Tanner stage) and aged 9-14.9. The mean duration of disease was 19.8 and 19.5 years for prepubertal and pubertal patients, respectively. In all patients, retinal photographs were taken and centrally graded. Urinary albumin excretion (UAE; 86 case subjects), blood pressure (BP; 89 case subjects), and lifetime HbA 1c (72 case subjects) were also evaluated.RESULTS - The prevalence of diabetic retinopathy (DR) was higher in pubertal than in prepubertal patients, both for any grade DR (71 vs. 40%, P = 0.002) and for mild or more severe DR (P = 0.005). The prevalence of abnormal UAE was not different in the two groups. Hypertension was found only in three patients, all pubertal at diagnosis. In the small group with moderate-to-severe DR, lifetime HbA 1c levels, as percentages above the upper normal reference value, were higher (P <0.01) in prepubertal than in pubertal patients. CONCLUSIONS - If diabetes is diagnosed in infants or toddlers and the prepubertal duration of diabetes is very long, the patients seem to be protected against DR. This protection disappears if lifetime metabolic control is bad. Instead, when onset is at puberty, the DR risk is higher and less dependent on metabolic control and may be influenced by age-related factors, such as BP.

Original languageEnglish
Pages (from-to)829-833
Number of pages5
JournalDiabetes Care
Volume35
Issue number4
DOIs
Publication statusPublished - Apr 2012

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Diabetes Complications
Type 1 Diabetes Mellitus
Diabetic Retinopathy
Reference Values
Age Factors
Puberty
Multicenter Studies
Albumins
Research Design
Blood Pressure
Hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

Cite this

Salardi, S., Porta, M., Maltoni, G., Rubbi, F., Rovere, S., Cerutti, F., ... Zucchini, S. (2012). Infant and toddler type 1 diabetes: Complications after 20 years' duration. Diabetes Care, 35(4), 829-833. https://doi.org/10.2337/dc11-1489

Infant and toddler type 1 diabetes : Complications after 20 years' duration. / Salardi, Silvana; Porta, Massimo; Maltoni, Giulio; Rubbi, Flavia; Rovere, Silvia; Cerutti, Franco; Iafusco, Dario; Tumini, Stefano; Cauvin, Vittoria; Cadario, Francesco; D'Annunzio, Giuseppe; Salvatoni, Alessandro; Schiaffini, Riccardo; Toni, Sonia; Zedda, Maria Antonietta; Zucchini, Stefano.

In: Diabetes Care, Vol. 35, No. 4, 04.2012, p. 829-833.

Research output: Contribution to journalArticle

Salardi, S, Porta, M, Maltoni, G, Rubbi, F, Rovere, S, Cerutti, F, Iafusco, D, Tumini, S, Cauvin, V, Cadario, F, D'Annunzio, G, Salvatoni, A, Schiaffini, R, Toni, S, Zedda, MA & Zucchini, S 2012, 'Infant and toddler type 1 diabetes: Complications after 20 years' duration', Diabetes Care, vol. 35, no. 4, pp. 829-833. https://doi.org/10.2337/dc11-1489
Salardi S, Porta M, Maltoni G, Rubbi F, Rovere S, Cerutti F et al. Infant and toddler type 1 diabetes: Complications after 20 years' duration. Diabetes Care. 2012 Apr;35(4):829-833. https://doi.org/10.2337/dc11-1489
Salardi, Silvana ; Porta, Massimo ; Maltoni, Giulio ; Rubbi, Flavia ; Rovere, Silvia ; Cerutti, Franco ; Iafusco, Dario ; Tumini, Stefano ; Cauvin, Vittoria ; Cadario, Francesco ; D'Annunzio, Giuseppe ; Salvatoni, Alessandro ; Schiaffini, Riccardo ; Toni, Sonia ; Zedda, Maria Antonietta ; Zucchini, Stefano. / Infant and toddler type 1 diabetes : Complications after 20 years' duration. In: Diabetes Care. 2012 ; Vol. 35, No. 4. pp. 829-833.
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abstract = "OBJECTIVE - To compare the effect of the prepubertal duration of diabetes on the occurrence of complications in two groups of patients after the same number of years of the disease. RESEARCH DESIGN AND METHODS - This multicenter study enrolled 105 patients aged 16-40.3 years; 53 were prepubertal at diagnosis (aged 0-3) and 52 were pubertal (Tanner stage) and aged 9-14.9. The mean duration of disease was 19.8 and 19.5 years for prepubertal and pubertal patients, respectively. In all patients, retinal photographs were taken and centrally graded. Urinary albumin excretion (UAE; 86 case subjects), blood pressure (BP; 89 case subjects), and lifetime HbA 1c (72 case subjects) were also evaluated.RESULTS - The prevalence of diabetic retinopathy (DR) was higher in pubertal than in prepubertal patients, both for any grade DR (71 vs. 40{\%}, P = 0.002) and for mild or more severe DR (P = 0.005). The prevalence of abnormal UAE was not different in the two groups. Hypertension was found only in three patients, all pubertal at diagnosis. In the small group with moderate-to-severe DR, lifetime HbA 1c levels, as percentages above the upper normal reference value, were higher (P <0.01) in prepubertal than in pubertal patients. CONCLUSIONS - If diabetes is diagnosed in infants or toddlers and the prepubertal duration of diabetes is very long, the patients seem to be protected against DR. This protection disappears if lifetime metabolic control is bad. Instead, when onset is at puberty, the DR risk is higher and less dependent on metabolic control and may be influenced by age-related factors, such as BP.",
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T2 - Complications after 20 years' duration

AU - Salardi, Silvana

AU - Porta, Massimo

AU - Maltoni, Giulio

AU - Rubbi, Flavia

AU - Rovere, Silvia

AU - Cerutti, Franco

AU - Iafusco, Dario

AU - Tumini, Stefano

AU - Cauvin, Vittoria

AU - Cadario, Francesco

AU - D'Annunzio, Giuseppe

AU - Salvatoni, Alessandro

AU - Schiaffini, Riccardo

AU - Toni, Sonia

AU - Zedda, Maria Antonietta

AU - Zucchini, Stefano

PY - 2012/4

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N2 - OBJECTIVE - To compare the effect of the prepubertal duration of diabetes on the occurrence of complications in two groups of patients after the same number of years of the disease. RESEARCH DESIGN AND METHODS - This multicenter study enrolled 105 patients aged 16-40.3 years; 53 were prepubertal at diagnosis (aged 0-3) and 52 were pubertal (Tanner stage) and aged 9-14.9. The mean duration of disease was 19.8 and 19.5 years for prepubertal and pubertal patients, respectively. In all patients, retinal photographs were taken and centrally graded. Urinary albumin excretion (UAE; 86 case subjects), blood pressure (BP; 89 case subjects), and lifetime HbA 1c (72 case subjects) were also evaluated.RESULTS - The prevalence of diabetic retinopathy (DR) was higher in pubertal than in prepubertal patients, both for any grade DR (71 vs. 40%, P = 0.002) and for mild or more severe DR (P = 0.005). The prevalence of abnormal UAE was not different in the two groups. Hypertension was found only in three patients, all pubertal at diagnosis. In the small group with moderate-to-severe DR, lifetime HbA 1c levels, as percentages above the upper normal reference value, were higher (P <0.01) in prepubertal than in pubertal patients. CONCLUSIONS - If diabetes is diagnosed in infants or toddlers and the prepubertal duration of diabetes is very long, the patients seem to be protected against DR. This protection disappears if lifetime metabolic control is bad. Instead, when onset is at puberty, the DR risk is higher and less dependent on metabolic control and may be influenced by age-related factors, such as BP.

AB - OBJECTIVE - To compare the effect of the prepubertal duration of diabetes on the occurrence of complications in two groups of patients after the same number of years of the disease. RESEARCH DESIGN AND METHODS - This multicenter study enrolled 105 patients aged 16-40.3 years; 53 were prepubertal at diagnosis (aged 0-3) and 52 were pubertal (Tanner stage) and aged 9-14.9. The mean duration of disease was 19.8 and 19.5 years for prepubertal and pubertal patients, respectively. In all patients, retinal photographs were taken and centrally graded. Urinary albumin excretion (UAE; 86 case subjects), blood pressure (BP; 89 case subjects), and lifetime HbA 1c (72 case subjects) were also evaluated.RESULTS - The prevalence of diabetic retinopathy (DR) was higher in pubertal than in prepubertal patients, both for any grade DR (71 vs. 40%, P = 0.002) and for mild or more severe DR (P = 0.005). The prevalence of abnormal UAE was not different in the two groups. Hypertension was found only in three patients, all pubertal at diagnosis. In the small group with moderate-to-severe DR, lifetime HbA 1c levels, as percentages above the upper normal reference value, were higher (P <0.01) in prepubertal than in pubertal patients. CONCLUSIONS - If diabetes is diagnosed in infants or toddlers and the prepubertal duration of diabetes is very long, the patients seem to be protected against DR. This protection disappears if lifetime metabolic control is bad. Instead, when onset is at puberty, the DR risk is higher and less dependent on metabolic control and may be influenced by age-related factors, such as BP.

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