A Soehnle Professional Range was utilized for evaluation of anthropometric parameters, and body weight was measured at diagnosis and during each outpatient visit to the Diabetic Medical center. familial autoimmunity more often exhibited GADA autoantibody positivity at diagnosis. The Solanesol larger the number of the patients relatives diagnosed with an autoimmune disease, the higher were the patients GADA levels (Spearmans rho test?=?0.19, p?=?0.049). Children with a first-degree relative with autoimmunity experienced a coexisting autoimmune disorder at a significantly higher percentage (p?=?0.016). Family history of autoimmunity was negatively associated with the presence of diabetic ketoacidosis (DKA) (p?=?0.024). Patients with a relative with T1D less frequently exhibited DKA at diagnosis (12.8 vs. 87.2%, p?=?0.003). The presence of DKA was associated with more youthful age (p?=?0.05) and reduce c-peptide levels (p?=?0.033). Conclusions Familial autoimmunity was TRADD present in 62.8% of children with T1D, autoimmune thyroiditis and T1D being the two most frequent familial autoimmune diseases. Familial autoimmunity reduced the risk of DKA at diagnosis, but these patients were more youthful and experienced higher levels of pancreatic autoantibodies and a greater risk of developing additional autoimmune diseases. strong class=”kwd-title” Keywords: Diabetes mellitus, Child years, Adolescence, Autoimmune disease, Family Introduction The incidence of diabetes mellitus type 1 (T1D) in child years is estimated at 6.5??104 cases/year. Diabetic ketoacidosis (DKA) as the first presentation of the disease occurs often and is well recognized as the main cause of death at diabetes diagnosis due to severe adverse events such as electrolytic disturbances, brain edema, and coma [1]. Additionally, DKA is usually accompanied by lower c-peptide levels due to decreased residual beta cell function [2]. During the course of diabetes, DKA is usually correlated with poor glycemic control and neurocognitive deficits, as well as elevated health care costs [3C6]. According to previous reports, severe DKA as the first presentation of T1D is usually more often observed in children without family history of T1D or other autoimmune diseases [5, 7, 8]. On the contrary, children belonging to a family with at least one first-degree relative with T1D exhibit six occasions lower risk of DKA as the first manifestation of T1D [9]. This is attributed to timely identification of the initial symptoms of T1D by the experienced family members. A report published by Hekkala et al. concluded that children with a family history of T1D or T2D are less likely to exhibit DKA as the first manifestation of the disease [10]. Additionally, a review article by Usher-Smith et al. underlines the fact that within a family with at least two users with T1D, the first to be diagnosed with the disease was at higher risk of developing severe DKA at the time of diagnosis [9]. The aim of the present study was to investigate whether DKA presence and severity at T1D diagnosis may be related to pre-existing familial autoimmunity as well as to assess whether the history of other autoimmune diseases within the family constitutes a risk factor for developing T1D and/or additional autoimmune diseases during the course of diabetes. Additionally, we explored a possible link between familial autoimmunity and age at T1D diagnosis, along with the presence and titers of pancreatic autoantibodies. Methods The study populace consisted of 121 children, adolescents, and young adults with T1D (male/female ratio: Solanesol 63/58) followed up by the Diabetes and Metabolism Medical center of the Second Department of Pediatrics of the National and Kapodistrian University or college Solanesol of Athens, P. & A. Kyriakou Childrens Hospital, Athens, Greece, from January 2002 to December 2016. The participants age ranged from 1 to 20 y, age at T1D onset was 1C15 y, and disease duration ranged from 2?months to 14.5?years. T1D and DKA diagnosis and severity were based on the International Society of Pediatric and Adolescent Diabetes (ISPAD) criteria [11]. Patients with incomplete medical records were excluded from the study. Approval of the Ethics Committee was obtained. This is a retrospective populace study. Age at T1D diagnosis, presence of pancreatic autoimmunity, and familial autoimmunity were considered as risk factors, while severity of initial T1D clinical presentation (DKA, DKA severity, or coma) was considered as the outcome. Familial autoimmunity was defined as the presence of at least one autoimmune disease either among first-degree relatives (nuclear family) or among second- and third-degree relatives (extended family). The following parameters were extracted and documented from the patients medical.