Study of children with type 1 diabetes mellitus of long duration attending the Alexandria University Children’s Hospital

Background Despite the advances in treatment of type 1 diabetes mellitus (T1DM), diabetic complications constitute the main cause of morbidity and mortality. Moreover, T1DM is often associated with other autoimmune diseases. Aim To study children with T1DM of long duration, attending the diabetes clinic of Alexandria University Children’s Hospital, regarding the glycemic control and presence of complications and associated autoimmune diseases. Patients and methods A total of 50 children and adolescents with T1DM of more than or equal to 5-year duration were assessed for the presence of diabetic complications and their relation to the glycemic control and duration of diabetes. The investigations included glycosylated hemoglobin, estimated glomerular filtration rate, microalbuminuria, complete liver profile, lipid profile, thyroid profile, tests for celiac disease, abdominal ultrasound, fundus examination, and echocardiography. Results The majority (70%) of the patients had poor glycemic control, and 64% of them were receiving premixed insulin. Lipohypertrophy, fatty liver, dyslipidemia, and nephropathy were very prevalent complications. Hypothyroidism, neuropathy, and celiac disease were less common complications. Conclusion All our diabetic patients should be treated with basal-bolus insulin, with emphasis on education about proper comprehensive management of the disease.