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RESEARCH PRODUCT

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

Grazyna DejaPrzemysława Jarosz-chobotJoanna StompórKarolina SzydaAgata ChobotMagdalena SokołowskaJoanna Polanska

subject

Malemedicine.medical_specialtyMultivariate analysisAdolescentEndocrinology Diabetes and Metabolismmedicine.medical_treatment030209 endocrinology & metabolismGastroenterologyDiabetic Ketoacidosis03 medical and health sciences0302 clinical medicineInternal medicineRemission phaseInternal MedicinemedicineHumans030212 general & internal medicineAge of OnsetChildGlycated HemoglobinType 1 diabetesbusiness.industryInsulinRemission InductionAge Factorsmedicine.diseaseKetoacidosisDiabetes Mellitus Type 1Child PreschoolConcomitantPediatrics Perinatology and Child HealthFemaleObservational studyPolandbusinessBody mass index

description

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 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.

https://doi.org/10.1111/pedi.12824