P-504: Type 1 diabetes in multiplex families: from diagnosis to family experience
S Benchikh, A S Bendeddouche, D SenouciAbstract
Introduction
Type 1 diabetes (T1D) is a chronic condition with significant impact on both children and their families. While most cases are sporadic, a minority occur in familial clusters.
Objectives
To analyze diagnostic features, metabolic control, diabetes management, and the psycho-familial impact among children with type 1 diabetes from multiplex families.
Methods
Among 722 children followed since 2014 at the pediatric department of Tlemcen University Hospital, 17 multiplex families including at least two diabetic children were identified. These families comprised 35 patients (18 girls, 17 boys), with a mean age of 14.6 ± 10 years. Data were retrospectively collected from medical records and analyzed descriptively.
Results
Multiplex cases represented 4.8% of the cohort. Mean age at diagnosis was 6.4 years, with an average interval of 4.2 years between the first and second affected child. Polyuria–polydipsia syndrome was the most common presentation. Diabetic ketoacidosis and incidental diagnoses accounted for 8.6% and 8% of cases, respectively. Immunological markers were positive in 68% of patients, predominantly anti-GAD antibodies. Mean HbA1c was 10%, indicating suboptimal glycemic control. HbA1c levels were generally similar within families, except for two with marked variability. A significant increase in HbA1c was observed in the first child following diagnosis of the second. Treatment adherence and autonomy were satisfactory in most patients, with 80% demonstrating independence and 90% recognizing glycemic imbalance symptoms. However, regular glucose monitoring was insufficient (50%). Quality of life was mildly, moderately, and severely impaired in 36%, 27%, and 36% of families, respectively.
Conclusions
T1D in multiplex families is associated with substantial psycho-familial burden. Multidisciplinary care, including tailored therapeutic education and psychological support, is essential to improve glycemic control and quality of life.