Clinical characteristics and development of complications differ between adult-onset and child–adolescent-onset type 1 diabetes: A report from a tertiary medical center in Türkiye

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dc.authorid0000-0003-3815-7444
dc.authorid0000-0001-7566-5427
dc.authorid0000-0002-1074-1801
dc.authorid0000-0002-5259-7326
dc.authorid0000-0002-6365-4621
dc.authorid0000-0002-1263-791X
dc.authorid0000-0002-5057-2651
dc.authorid0000-0002-3646-6991
dc.authorid0000-0003-0340-1494
dc.authorid0000-0001-8613-1797
dc.contributor.authorÇakmak, Ramazan
dc.contributor.authorTelci Çaklılı, Özge
dc.contributor.authorOk, Ayşe Merve
dc.contributor.authorMutlu, Ümmü
dc.contributor.authorSarıbeyliler, Göktuğ
dc.contributor.authorSeferova Nasifova, Vefa
dc.contributor.authorBilgin, Ersel
dc.contributor.authorÇoşkun, Aylin
dc.contributor.authorGüzey, Damla Yenersu
dc.contributor.authorSatman, İlhan
dc.date.accessioned2025-04-29T11:38:55Z
dc.date.available2025-04-29T11:38:55Z
dc.date.issued2025
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractBackground and Aims: The age-at-onset is of great importance in the heterogeneity of Type 1 diabetes mellitus (T1DM). This study was designed to define clinical and laboratory differences between child–adolescent-onset and adult-onset T1DM at presentation and during follow-up and determine the predicting factors for developing microvascular and macrovascular complications. Material and Methods: This retrospective observational study evaluated T1DM patients who were followed in the diabetes outpatient clinic between January 1, 2000, and December 31, 2019. Results: The study cohort included 490 individuals with T1DM (54.3% female, 58.8% adult-onset, and median follow-up: 5 years). In the adult-onset group, baseline C-peptide and GADA prevalence were higher, whereas presentation with ketoacidosis was 2.3-fold lower compared to the child–adolescent-onset group (p < 0.001). During follow-up, the adult-onset group had a 2.4-fold higher overweight/obesity (p < 0.001) and 1.7-fold higher dyslipidemia/hyperlipidemia (p = 0.002) than the child–adolescent-onset group. In multivariate analysis, fasting glucose (p = 0.024) in adult-onset, dyslipidemia/hyperlipidemia (p = 0.037) in child–adolescent-onset, and diabetes duration (p = 0.008 and p = 0.007) and hypertension (p = 0.001 and p = 0.01) in both groups were associated with increased risk of microvascular complications, whereas age-at-onset (p = 0.024), dyslipidemia/hyperlipidemia (p = 0.03), nephropathy (p = 0.003), and neuropathy (p = 0.001) in adult-onset and age (p = 0.002) and triglycerides (p = 0.013) in child–adolescent-onset groups were associated with increased risk of macrovascular complications. The cutoff C-peptide levels at baseline predicted microvascular complications in the whole cohort and adult-onset group were defined as 0.383 ng/mL (p < 0.001) and 0.41 ng/mL (p = 0.001), respectively. In the Kaplan–Meier analysis, C-peptide (< 0.383 ng/mL) but not age-at-onset predicted future development of microvascular and macrovascular complications (p = 0.003 and p = 0.032). Conclusion: Clinical presentation and prognosis differ in adult-onset and child–adolescent-onset T1DM. Low initial C-peptide may predict the development of microvascular and macrovascular complications.
dc.identifier.citationÇakmak, R., Telci Çaklılı, Ö., Ok, A. M., Mutlu, Ü., Sarıbeyliler, G., Seferova Nasifova, V., Bilgin, E., Çoşkun, A., Güzey, D. Y., & Satman, İ. (2025). Clinical characteristics and development of complications differ between adult-onset and child–adolescent-onset type 1 diabetes: A report from a tertiary medical center in Türkiye. Journal of Diabetes Research, 2025(1), pp. 1-16. https://doi.org/10.1155/jdr/8860118
dc.identifier.doi10.1155/jdr/8860118
dc.identifier.endpage16
dc.identifier.issn2314-6745
dc.identifier.issn2314-6753
dc.identifier.issue1
dc.identifier.pmidPMID: 40241936
dc.identifier.scopus2-s2.0-105002467185
dc.identifier.scopusqualityQ1
dc.identifier.startpage1
dc.identifier.urihttps://doi.org/10.1155/jdr/8860118
dc.identifier.urihttps://hdl.handle.net/20.500.13055/963
dc.identifier.volume2025
dc.identifier.wosWOS:001463213900001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorÇakmak, Ramazan
dc.institutionauthorid0000-0003-3815-7444
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofJournal of Diabetes Research
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectAdult-Onset Type 1 Diabetes
dc.subjectChild–Adolescent-Onset Type 1 Diabetes
dc.subjectC-Peptide
dc.subjectDiabetic Ketoacidosis
dc.subjectMicrovascular Complications
dc.titleClinical characteristics and development of complications differ between adult-onset and child–adolescent-onset type 1 diabetes: A report from a tertiary medical center in Türkiye
dc.typeArticle
dspace.entity.typePublication

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