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    Trends and clinical features of childhood diabetes subgroups: 28 years of single center experience
    (Turkish J Pediatrics, 2025) Dundar, Ismail; Akinci, Aysehan; Camtosun, Emine; Yilmaz, Zeynep Yamancan; Kaya, Eda
    Objective. This study aimed to explore the distribution, trends, and clinical characteristics of various types of childhood diabetes, including type 1 diabetes (T1DM), type 2 diabetes (T2DM), and maturity-onset diabetes of the young (MODY) in a tertiary health center. Methods. We conducted a comprehensive review of medical records of individuals aged 0-18 years who were diagnosed with diabetes between January 1996 and December 2023. Clinical and laboratory characteristics at the time of diagnosis, along with the specific diabetes type, were meticulously documented. Results. A total of 1219 patients were included in the study, of whom 48.4% were female, with a mean age at diagnosis of 9.1 +/- 4.3 years. T1DM was diagnosed in 85.8% of patients, T2DM in 6.3%, clinical MODY in 5.2%, and rare forms of diabetes in 2.6%. An increasing trend in T2DM and MODY cases has been observed since 2007. Diabetic ketoacidosis (DKA) was most prevalent in T1DM (47.1%), followed by T2DM (5.2%) and MODY (1.6%). Mean C-peptide levels at diagnosis were 0.57 +/- 0.5 ng/mL in T1DM, 3.2 +/- 1.3 ng/mL in T2DM, and 1.4 +/- 0.9 ng/mL in MODY. Antibody positivity was observed in 78.8% of T1DM, 6.5% of T2DM, and 15.9% of MODY cases. Among the MODY group, genetic analysis was performed in 48 (75%) patients, with GCK gene mutations identified as the most common genetic abnormality in 27 (56.2%) of these patients. Conclusion. This study demonstrates that T1DM is still the most commonly diagnosed type of diabetes in childhood, while T2DM and MODY are less frequent. However, a temporal increase in the incidence of MODY and T2DM subtypes was observed. The incidence of DKA at diagnosis was significantly higher in T1DM patients compared with those diagnosed with MODY or T2DM.