{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:37:33Z","timestamp":1773794253065,"version":"3.50.1"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":98,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background and Aims:<\/jats:bold>\n                    The age\u2010at\u2010onset is of great importance in the heterogeneity of Type 1 diabetes mellitus (T1DM). This study was designed to define clinical and laboratory differences between child\u2013adolescent\u2010onset and adult\u2010onset T1DM at presentation and during follow\u2010up and determine the predicting factors for developing microvascular and macrovascular complications.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Material and Methods:<\/jats:bold>\n                    This retrospective observational study evaluated T1DM patients who were followed in the diabetes outpatient clinic between January 1, 2000, and December 31, 2019.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The study cohort included 490 individuals with T1DM (54.3% female, 58.8% adult\u2010onset, and median follow\u2010up: 5 years). In the adult\u2010onset group, baseline C\u2010peptide and GADA prevalence were higher, whereas presentation with ketoacidosis was 2.3\u2010fold lower compared to the child\u2013adolescent\u2010onset group (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001). During follow\u2010up, the adult\u2010onset group had a 2.4\u2010fold higher overweight\/obesity (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001) and 1.7\u2010fold higher dyslipidemia\/hyperlipidemia (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.002) than the child\u2013adolescent\u2010onset group. In multivariate analysis, fasting glucose (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.024) in adult\u2010onset, dyslipidemia\/hyperlipidemia (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.037) in child\u2013adolescent\u2010onset, and diabetes duration (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.008 and\n                    <jats:italic>p<\/jats:italic>\n                    = 0.007) and hypertension (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.001 and\n                    <jats:italic>p<\/jats:italic>\n                    = 0.01) in both groups were associated with increased risk of microvascular complications, whereas age\u2010at\u2010onset (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.024), dyslipidemia\/hyperlipidemia (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.03), nephropathy (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.003), and neuropathy (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.001) in adult\u2010onset and age (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.002) and triglycerides (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.013) in child\u2013adolescent\u2010onset groups were associated with increased risk of macrovascular complications. The cutoff C\u2010peptide levels at baseline predicted microvascular complications in the whole cohort and adult\u2010onset group were defined as 0.383\u2009ng\/mL (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001) and 0.41\u2009ng\/mL (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.001), respectively. In the Kaplan\u2013Meier analysis, C\u2010peptide (&lt;\u20090.383\u2009ng\/mL) but not age\u2010at\u2010onset predicted future development of microvascular and macrovascular complications (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.003 and\n                    <jats:italic>p<\/jats:italic>\n                    = 0.032).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Clinical presentation and prognosis differ in adult\u2010onset and child\u2013adolescent\u2010onset T1DM. Low initial C\u2010peptide may predict the development of microvascular and macrovascular complications.\n                  <\/jats:p>","DOI":"10.1155\/jdr\/8860118","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T14:50:18Z","timestamp":1744210218000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Characteristics and Development of Complications Differ Between Adult\u2010Onset and Child\u2013Adolescent\u2010Onset Type 1 Diabetes: A Report From a Tertiary Medical Center in T\u00fcrkiye"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3815-7444","authenticated-orcid":false,"given":"Ramazan","family":"\u00c7akmak","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7566-5427","authenticated-orcid":false,"given":"\u00d6zge 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