ABSTRACT
Objective: To study glycemic control, mortality and long-termcomplications in children with type 1 diabetes (T1D).Design: Cross-sectional study.Setting: Referral centre at a government teaching hospital.Participants: Patients with T1D with age ≤18 years at onset.Methods: We retrospectively collected demographic data fromcomputer records from 1991 to 2015. Prospective study foroutcomes was conducted between 2012 and 2016.Main outcome measures: Mortality rate, glycosylatedhemoglobin (HbA1c), and microvascular complication rate.Results: The proportion of T1D patients (n=512) <5 years of ageat onset was 18.6% between 1995 and 2004, and 24.2% in2005-2014 (P<0.001). Twenty eight patients had died out of 334whose living status was known (mortality 1.1 per 100 patient-years over 2549 patient-years follow up). Median (range)HbA1c (n=257) was 8.3% (5.1-15.0%). At least one episode ofsevere hypoglycemia (coma/seizure/inability to assist self) hadoccurred in 22.8% patients over two years. Hypertension waspresent in 11.7% patients. Microvascular complications screenin 164 eligible patients [median (range) age 20 (8-45) y andduration of diabetes 9.1 (5-30) y] showed diabetic nephropathy in3.0%, proliferative retinopathy in 3.6% and LDL cholesterol >100mg/dL in 34% patients.Conclusion: The mortality rate and prevalence of hypertensionwere high, given the short duration of diabetes of the patients.The proportion of patients with age ≤5 years at onset of diabeteshas increased at our center.