Comparison of internet usage and internet addiction scores in healthy children and children with type 1 diabetes mellitus.

OBJECTIVES: The Internet, an integral part of modern life, can lead to internet addiction, which negatively affects academic performance, family relationships, and emotional development. This study aimed to evaluate the Internet addiction scores (IAS) during COVID-19 in children with type 1 diabetes mellitus (T1DM) compared with healthy controls. METHODS: Children with T1DM and healthy controls aged 8-18, were evaluated with the Parent-Child Internet Addiction Test (PCIAT20). Internet addiction scores of the participants were assessed. The relationship between diabetes duration, mean HbA1c level and IAS were also examined in children with T1DM. RESULTS: The study included 139 patients with T1DM and 273 controls. The IAS were significantly lower in patients compared with controls (25.28 ± 15.52 vs. 29.69 ± 19.08, p=0.019). There was a weak negative correlation between the duration of diabetes and IAS in children with diabetes (r=-0.21, p=0.021). There was no significant association between IAS and mean HbA1c (r=0.14, p=0.128) or age (r=0.08, p=0.115). Furthermore, there was no statistically significant difference in IAS between children with well-controlled diabetes (n=17) and those with poorly-controlled diabetes (n=122) (IAS: 27.1 ± 17.2; 24.8 ± 15.5, p=0.672, respectively). CONCLUSIONS: Internet addiction scores were lower in patients with T1DM compared with their healthy peers. Unlike previous studies reporting an increase in problematic internet use, the results of the present study did not confirm internet use as a real challenge in front of the diabetes management for the majority of children with T1DM. This result may be attributed to the important role played by families in the management of T1DM.

The First Case of 4H Syndrome with Type 1 Diabetes Mellitus.

4H syndrome is a rare progressive hypomyelinating leukodystrophy. Hypomyelination, hypodontia, and hypogonadotropic hypogonadism are the 3 classic features of 4H syndrome. Biallelic pathogenic variants in POLR3A, POLR3B, POLR1C, and POLR3K gene cause 4H leukodystrophy. Herein, we present clinical features in two siblings with 4H syndrome. The first patient (16 years) presented hypogonadotropic hypogonadism, euthyroid Hashimoto's thyroiditis and type 1 diabetes mellitus. The second patient (13.5 years) showed normal physical, biochemical and hormonal examination at presentation. It was learned that he was followed up for epilepsy between the ages of 6 months and 6 years, his epilepsy medication was discontinued at the age of 6, and he did not have seizure again. T2-weighted magnetic resonance images showed increased signal intensity secondary to hypomyelination at patients. They were subsequently found to have homozygous mutation in the POLR3A gene. 4H syndrome may present with neurological and non-neurological findings in addition to classic features of 4H syndrome. Progressive neurological deterioration may occur and endocrine dysfunction may be progressive. Although multipl endocrine abnormalities associated with this disorder have been reported to date, a case accompanied by type 1 DM has not been seen in the literature. We do not know exactly whether this is coinsidans or the expansion of the phenotype. So that reporting such cases helps to determine the appropriate genotype-phenotype correlation in patients.