Risk Factors of Type 1 Diabetes Mellitus among Egyptian Infants: A Case-Control Study

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Abstract
Background: Diabetes mellitus type 1 (T1DM) is the most common endocrine metabolic disorder in children and adolescents. Age, gender, race, genotype, seasonality and viral infection are the main T1DM risk factors that have been identified. Aim of the study: was to describe the clinical characteristics and laboratory findings and the different risk factors in infants who developed diabetes mellitus during the first two years of their life. Methods: A case control study was conducted in pediatric outpatient endocrine clinic, Zagazig University Hospitals. It included 34 diabetic infants and 34 healthy infants in the 1 st 2 years of life. For all subjects, we performed random blood sugar, glycosylated hemoglobin (HbA1C) and anti-islet cell antibody by indirect immunofluoresent assay. Results: More than two thirds of the studied type 1 diabetic infants were detected at 12-24 months of age. There was no statistical significant association between predisposing risk factors of type 1 DM and the age of onset except for high birth weight (HBW) and positive family history of DM (27.3% and 90.9% respectively) at <12 months of age (p <0.05). Polyuria, polydipsia, weight loss, and diabetic ketoacidosis (DKA) were the most frequent presentations among the studied type 1 diabetic patients (93.3%, 73.3%, & 53.3% respectively). There was statistical significant differences in the means of RBG & HbA1C among cases and controls (p <0.05).Fasting serum C-peptide level was significantly lower among type 1 diabetic infants at age 12 months or more (p <0.05). Islet cell antibodies were negative in both patients and controls by indirect immunoflourescene assay. Conclusion: Avoidance of predisposing factors in infantile DM may help to delay the onset of disease but does not prevent it especially if genetically determined.

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