Characteristics of Adult vs. Childhood-Onset Type 1 Diabetes (T1D) in the T1D Exchange Registry
Authors: PETERS ANNE L. , KANAPKA LAUREN , HIRSCH IRL B. , LAFFEL LORI M. , DESALVO DANIEL J. , LYONS SARAH , VENDRAME FRANCESCO , ALEPPO GRAZIA , MASTRANDREA LUCY D. , PRATLEY RICHARD E. , RICKELS MICHAEL R. 
Published: June 2018

We aimed to compare diagnosis characteristics, diabetes management, and comorbidities to identify differences between childhood and adult onset T1D. This analysis was performed in the T1D Exchange registry across the following age at diagnosis groups: &lt;10, 10-17, 18-24, 25-39, and ≥40 years. Diagnosis characteristics were compared using a regression model adjusting for possible confounders. Current characteristics came from the participant’s most recent clinic exam and were restricted to those with current age ≥25 years and T1D duration ≥1 year. For each outcome, two models were fit, one including adjustment for current age and one including adjustment for T1D duration. Age at diagnosis was associated with an outcome if an association was present and the direction of effect was consistent across models. DKA at diagnosis was more common at childhood onset. The use of oral agents preceding diagnosis was higher in participants diagnosed as adults, likely due to initial misdiagnosis as type 2 (Table). Current pump use and celiac disease were more frequent in participants diagnosed at younger ages; however, HbA1c, CGM use, insulin requirements, and other comorbidities were not significantly different across age at diagnosis groups. A better understanding of differences in persons diagnosed with T1D as children vs. adults is needed to understand prognosis and subtype-specific therapeutic approaches.

Disclosure

A.L. Peters: Advisory Panel; Self; Abbott, Bigfoot Biomedical. Research Support; Self; Dexcom, Inc.. Advisory Panel; Self; Eli Lilly and Company, Insulin Algorithms, JDRF, Lexicon Pharmaceuticals, Inc., Livongo Health. Research Support; Self; MannKind Corporation. Other Relationship; Self; Medscape. Advisory Panel; Self; Merck & Co., Inc.. Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases. Speaker's Bureau; Self; Novo Nordisk Inc.. Advisory Panel; Self; Novo Nordisk Inc., Omada Health, Inc., Optum Rx, Inc., Sanofi. Research Support; Self; T1D Exchange. Advisory Panel; Self; The Endocrine Society. Research Support; Self; The Leona M. and Harry B. Helmsley Charitable Trust. Advisory Panel; Spouse/Partner; Johnson & Johnson Diabetes Institute, LLC. I.B. Hirsch: Research Support; Self; Medtronic MiniMed, Inc.. Consultant; Self; Abbott, Bigfoot Biomedical, Roche Diabetes Care Health and Digital Solutions, ADOCIA. L.M. Laffel: Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi US, MannKind Corporation, Roche Diagnostics Corporation, Dexcom, Inc., Insulet Corporation, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Johnson & Johnson Diabetes Institute, LLC. D.J. DeSalvo: Consultant; Self; Dexcom, Inc.. Speaker's Bureau; Self; Insulet Corporation. S. Lyons: None. F. Vendrame: Consultant; Self; Novo Nordisk Inc. G. Aleppo: Research Support; Self; AstraZeneca, Novo Nordisk Inc.. Consultant; Self; Dexcom, Inc.. Advisory Panel; Self; Novo Nordisk Inc. L.D. Mastrandrea: Research Support; Self; Novo Nordisk Inc., AstraZeneca, Sanofi-Aventis. Advisory Panel; Self; Pediatric Diabetes Consortium. Other Relationship; Self; American Academy of Pediatrics. Advisory Panel; Self; JAEB Center For Health Research. R.E. Pratley: Other Relationship; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eisai Inc., GlaxoSmithKline plc., Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Ligand Pharmaceuticals, Inc., Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Inc., Pfizer Inc., Sanofi-Aventis, Takeda Development Center Americas, Inc. M.R. Rickels: Consultant; Self; Hua Medicine, Xeris Pharmaceuticals, Inc..