Kidney disease rare with early type 1 diabetes onset

There may be a silver lining for kids who develop type 1 diabetes at a young age. They seem to be much less likely than children with later onset to develop kidney failure in adulthood, one of the feared consequences of the diabetes, investigators in Sweden report in the medical journal Diabetes Care.

Type 1 diabetes results when the insulin-producing cells in the pancreas are mistakenly destroyed by body's immune system, and it usually strikes in childhood.

In a population-based study, Dr. Maria Svensson, of Umea University Hospital, and colleagues used data from two nationwide registers, which include 12,032 cases of childhood onset of type 1 diabetes, to examine the cumulative occurrence of kidney failure caused by diabetes.

After a maximum follow-up of 27 years, the researchers found that 33 (0.7 percent) of 4414 patients who had had diabetes for more than 15 years developed diabetes-related end-stage renal disease (ESRD), which requires dialysis or a kidney transplant.

There was a significant difference in the risk of developing ESRD between the youngest age-at-onset group (0 to 4 years) and the older groups (5 to 14 years), the team reports. "No patients with onset of diabetes before 5 years of age had developed ESRD."

The researchers note that the mechanism behind the effect of age at onset is unclear. It has been suggested that when diabetes occurs near puberty, the hormonal changes, rapid growth and worsening of blood sugar regulation may accelerate the processes that lead to chronic diabetes complications.

SOURCE: Diabetes Care, March 2006.