Poster Presentation ESA-SRB-APEG-NZSE 2022

Aims

To compare demographic and presenting factors of the Type 1 Diabetes (T1D) patient cohorts from the New Patient Clinic (NPC) at the Queensland Children’s Hospital (QCH) in 2020-2021 and the Mater Hospital Clinic (MCH) in 2010.

To investigate factors that may potentially affect residual beta-cell function as determined by Estimated C-peptide (ECP).

Methods

Clinical data collected up to 12 months post diagnosis were obtained for patient cohorts diagnosed from June 2020 to July 2021 at QCH and MCH in 2010. ECP was calculated from a published algorithm at 3,6- and 12-months post diagnosis in the QCH cohort using the variables HbA1c, age, BMI, sex and total daily insulin dose (1). Subjects were stratified by age groups (0-5 years, 5-10 years and 10-15 years) to investigate rates of DKA and changes in ECP over time.  Comparisons between groups were analysed using ANOVA and Welch-Forsyth testing.

Results

Demographic data are shown in Table 1. QCH had a higher proportion of DKA (38.6% vs 33.3%) and moderate-severe DKA (21.6% vs 14.1%) at presentation. Children <5 years of age presented with a higher proportion of DKA (44.4%) and severe DKA (22%) compared to older children (21.9% in 5-10 year-olds, 6.3% severe and 38.2% in 10–15-year-olds, 11.8% severe). Younger age at diagnosis correlated with a decreased incidence of partial remission, as defined by ECP, and younger children also had a steeper decline in ECP in the first 12 months after diagnosis (Figure 1).

Conclusions

Compared to an historical cohort, the proportion of DKA presentations at diagnosis is higher.

Younger children (0-5 years) have a higher incidence of DKA and severe DKA than older children.

In younger patients, beta-cell function is lower after diagnosis and declines more rapidly in the first year compared to older children, indicating more aggressive disease.