[Complex analysis of the physical metabolic and genetic state in children of mothers with type 1 diabetes].

Background: Complex assessment of the development, clinical and immunological state of children born by mothers with type 1 diabetes, in the years 1998-2000.

Materials and methods: Material examined were 30 newborns, and subsequently 25 in the first, 30 children at 5-6 years of life. In newborns and in the 5-6 years the antibodies: IA-2A, IAA, ICA, anti GAD, insulin (IRI), peptide C were determined. In the first year HbA(1c), TSH, antigens HLA DQA1 and DQB1 were determined, in the 5th-6th years of life, the level of antibodies anti endomizium.

Results: Developmental anomalies in newborns were found in 6, in 3 in first and in the 5th-6th years in 4 children. Systemic infections were found in 6, hypoxia and prematurity in 12 newborns. A positive titer of anti GAD in 15, ICA in 18, IA-2A in 8, IAA in 18 newborns. In the first year of life, anti GAD in 2, in the 5-6th years in 4 children. In one child anti GAD was found during three examinations. In the case of this positive titer of antibodies, the allele DQB1*0302 was present. Allel DQB1*0302 was present in 28% of children, allele DQA1*0301 was absent. Mean levels of IRI afterbirth and in the first year of life were: 23.6 and 9.7 uIU/ml and peptide C 1.25 and 0.92 ng/ml. Mean levels of HbA(1c) in the first and 5th yrs of life were: x 6.2%, TSH 2.45 uIU/ml and 3.4 uIU/ml. Pathological values of antibodies anti endomizium were found in 4 children, biopsy of the small intestine confirmed coeliac disease. A normal body mass was seen in 9 newborns in 16 in the first, and 14 children 5-6 years of age. Deficiency in body mass was found in 2 newborns and 3 children in the first and 5-6th yrs. Macrosomia was found in 8 newborns in group I and 3 in group II. Overweight was found in 5 children in the first year and 9 in 5-6th yrs of life. None of the children have developed diabetes.

Conclusions: 1. Children of mothers with type 1 diabetes should be monitored by an outpatient clinic for diabetic patients. 2. Children of mothers with diabetes should have determined regularly immunological markers for diabetes and other autoimmunological disease.