Characteristics at diagnosis of type 1 diabetes in children younger than 6 years

Objective To characterize the prodrome, presentation, family history, and biochemical status at diagnosis of type 1 diabetes mellitus (T1D) in children under age 6 years. Study design This was a retrospective chart review of patients hospitalized at diagnosis with T1D from 1990 to 1999 in a children's hospital. Results A total of 247 children were hospitalized, 44% of whom presented in diabetic ketoacidosis (DKA). When stratified by 2-year age intervals, only total carbon dioxide (tCO 2 ) was significantly lower in the youngest children ( P = .02), and the duration of candidiasis was significantly longer in those children presenting in DKA ( P = .004). Parents were more likely to recognize symptomatic hyperglycemia in children older than 2 years ( P 2 were significantly correlated with hemoglobin A1c (HbA1c); age-adjusted HbA1c was 0.64% higher in girls compared with boys ( P = .045), and each 1-mmol/L decrement in tCO 2 increased the age- and gender-adjusted HbA1c by 0.086% ( P Conclusions A high proportion of children under age 6 years present critically ill at the diagnosis of T1D. When any of the classic symptoms of diabetes or a yeast infection is present, a serum glucose level should be measured.