الفهرس 
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Abstract
T1DM is multifactorial; family history and genetic predisposition, presence of autoantibodies, physical stress, and exposure to illnesses such as viral infections, disease of the pancreas, age, race, geography, and early diet are the main T1D risk factors that have been identified.
Environmental triggers in infancy and early childhood may accelerate the onset of diabetes.
Globally, the prevalence of DM is increasing by 3%-4% every year. There has been a steady increase in the incidence and prevalence of T1D, representing approximately 5% to 10% of people with diabetes. There is also a considerable geographic variation in incidence.
The disease clusters in some families, yet only about 13% of patients have a first-degree relative with type 1 diabetes. The risk of type 1 diabetes depends on which family members are affected; having multiple first-degree relatives with type 1 diabetes enhances the risk. Family history for type 2 diabetes has been reported in 1–70% of patients with T1D. Type 1 diabetes and type 2 diabetes have been shown to cluster in families.
Thus, the current study was conducted to identify the characteristics and environmental factors among an Egyptian cohort of children and adolescents with T1D living in El Beheira governorate and highlight effect of family history of TID and T2D on those children regarding clinical presentation and insulin requirements.
This cross-sectional study was conducted at the diabetes clinic in El-Beheira Governorate and included 119 children with T1DM regularly following up during the period from March 2023 until December 2023.
Of the 119 children with T1D from the diabetes clinic of El Beheira Governorate, males represented 35.3% and females were 64.7%. The median age at presentation was 6 yrs. Regarding the patients’ clinical presentation, hyperglycemia was reported in 66.4% of the studied cohort, and 31% of the studied cohort presented initially in DKA.
Among the studied cohort, only 10.9% of patients had a positive family history of T1D; 18.4% of our study population had T2D among their grandparents; and only 2.5% of the patients reported T2D among their immediate family members.
Patients with positive family history of T2D, were significantly older at presentation of T1D, however gender distribution was comparable among patients with and those without family history of T2D.
Regarding glycemic controls, patients with a positive family history of T2D had significantly higher values of HbA1c and they required higher doses of insulin. Similarly, both total cholesterol (P = 0.046) and triglycerides (P = 0.030) values were significantly higher among patients with a positive family history of T2D.
These findings could be attributed to factors related to insulin resistance in patients with family history of T2D. This hypothesis could be supported by the data showing that among patients with longer duration of T1D, markers related to both metabolic syndrome and insulin resistance have been associated with a positive family history for T2D.