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Characteristics and determinants of partial remission in children with type 1 diabetes using the insulin-dose-adjusted A1C definition.
Pecheur, Aurore; Barrea, Thierry; Vandooren, Valérie; Beauloye, Véronique; Robert, Annie; Lysy, Philippe A.
Afiliação
  • Pecheur A; Pediatric Endocrinology Unit, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium.
  • Barrea T; Pediatric Endocrinology Unit, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium.
  • Vandooren V; Pediatric Endocrinology Unit, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium.
  • Beauloye V; Pediatric Endocrinology Unit, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium.
  • Robert A; Pôle Epidémiologie et Biostatistique, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium.
  • Lysy PA; Pediatric Endocrinology Unit, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium.
J Diabetes Res ; 2014: 851378, 2014.
Article em En | MEDLINE | ID: mdl-25254220
To evaluate the characteristics and determinants of partial remission (PR) in Belgian children with type 1 diabetes (T1D), we analyzed records of 242 children from our center. Clinical and biological features were collected at diagnosis and during follow-up. PR was defined using the insulin-dose-adjusted A1C definition. PR occurred in 56.2% of patients and lasted 9.2 months (0.5 to 56.6). 25.6% of patients entered T1D with DKA, which correlated with lower PR incidence (17.6% versus 82.3% when no DKA). In our population, lower A1C levels at diagnosis were associated with higher PR incidence and in young children (0-4 years) initial A1C levels negatively correlated with longer PR. Early A1C levels were predictive of PR duration since 34% of patients had long PRs (>1 year) when A1C levels were ≤ 6% after 3 months whereas incidence of long PR decreased with higher A1Cs. C-peptide levels were higher in patients entering PR and remained higher until 3 years after diagnosis. Initial antibody titers did not influence PR except for anti-IA2 titers that correlated with A1C levels after 2 years. Presence of 2 versus 1 anti-islet antibodies correlated with shorter PR. PR duration did not influence occurrence of severe hypoglycemia or diabetes-related complications but was associated with lower A1C levels after 18 months. We show that, at diagnosis of T1D, parameters associated with ß-cell mass reserve (A1C, C-peptide, and DKA) correlate with the occurrence of PR, which affects post-PR A1C levels. Further research is needed to determine the long-term significance of PR.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hemoglobinas Glicadas / Diabetes Mellitus Tipo 1 / Insulina Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male País como assunto: Europa Idioma: En Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hemoglobinas Glicadas / Diabetes Mellitus Tipo 1 / Insulina Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male País como assunto: Europa Idioma: En Ano de publicação: 2014 Tipo de documento: Article