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Age at Diagnosis of Type 1 Diabetes Linked to Long-Term Outcomes

Patients diagnosed between 0 and 9 years of age were significantly less likely to have had a heart attack then those diagnosed between 10 and 13 years of age.

The age at diagnosis of childhood diabetes is associated with important health and behavioral outcomes later in life, according to a new study.

Dr. Aaron E. Carroll, of Indiana University, Indianapolis, writes, "Because self-care is such an essential element of successful diabetes management, cognitive and behavioral aspects of childhood development may interfere with effective self-care behaviors and impact the probability of later complications,"

The team used patient survey data from the Translating Research into Action for Diabetes (TRIAD) study to extract information on health and social outcomes in 590 patients diagnosed with diabetes at or before age 21.

Overall, 48.6% of the participants were diagnosed at 14 to 21 years of age, 29.5% were diagnosed between 0 and 9 years, and 21.9% were diagnosed between 10 and 13 years. Mean disease duration varied from 24.6 years among those diagnosed at an older age to 32.7 years among the group diagnosed at a younger age.

Patients diagnosed between ages 14 and 21 years were significantly heavier than those diagnosed between 10 and 13 years of age after adjusting for personal characteristics and disease duration.

"Interestingly," the investigators report, subjects diagnosed between the ages of 14 and 21 years were significantly less likely to have smoked in the last year (OR 0.45) than those diagnosed between the ages of 10 and 13 years.

No significant associations were observed between age at diabetes onset and stroke or quality of life.

"Diabetes is a difficult disease to manage under ideal conditions," Dr. Carroll’s team comments. "The unique demands of adolescent development, particularly the separation from parental norms and the development of a self-identity, clearly can impact the demands of diabetes treatment," they note. "Our data suggest that age at diagnosis may be an important factor in long-term outcomes associated with the disease."

Diabetes Care 2007;30:2859-2860.

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