Remission phase in children diagnosed with type 1 diabetes in years 2012 to 2013 in Silesia, Poland: an observational study

A Chobot, J Stompór, K Szyda, M Sokołowska… - Pediatric …, 2019 - Wiley Online Library
A Chobot, J Stompór, K Szyda, M Sokołowska, G Deja, J Polańska, P Jarosz‐Chobot
Pediatric diabetes, 2019Wiley Online Library
Background/Objective The study aimed to analyze the frequency of partial remission (PR)
and its association with chosen clinical and laboratory factors among pediatric patients with
newly diagnosed type 1 diabetes (T1D). The long‐term effect of PR on chosen parameters
was also investigated. Methods In 194 patients (95 girls) aged 8.1±4.3 years, we analyzed
data at T1D onset: glycemia, pH, C‐peptide, antibodies, weight, and concomitant
autoimmune diseases. Anthropometric parameters, daily insulin requirement (DIR), and …
Background/Objective
The study aimed to analyze the frequency of partial remission (PR) and its association with chosen clinical and laboratory factors among pediatric patients with newly diagnosed type 1 diabetes (T1D). The long‐term effect of PR on chosen parameters was also investigated.
Methods
In 194 patients (95 girls) aged 8.1 ± 4.3 years, we analyzed data at T1D onset: glycemia, pH, C‐peptide, antibodies, weight, and concomitant autoimmune diseases. Anthropometric parameters, daily insulin requirement (DIR), and HbA1c 2 and 4 years after T1D diagnosis were also analyzed. We determined PR based on HbA1c and DIR measurements at least every 3 months.
Results
PR occurred in 59% of patients. Remitters had significantly higher pH (7.33 vs 7.28, P = 0.03), weight SD score (SDS) (0.25 vs −0.24, P = 0.002), and body mass index SDS (0.19 vs −0.66, P = 0.02) compared with non‐remitters. Concomitant diseases correlated negatively with PR. Multivariate analysis indicated only pH at onset was an independent predictor of PR. pH was the most important factor associated with the beginning of PR. There was a positive correlation between the start and duration of PR. Four years after T1D onset remitters had lower HbA1c (7.24% vs 8.05%, 53 vs 63.9 mmol/mol, P < 0.001) and DIR (0.81 vs 1.08, P = 0.005).
Conclusions
PR occurred quite often and developed more frequently in children with higher: weight and BMI SDS, but the main factor influencing PR presence and duration was higher pH at T1D onset. There was a beneficial impact of PR on HbA1c and DIR after 4 years of treatment.
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