Reference : Multinational study in children and adolescents with newly diagnosed type 1 diabetes:...
Scientific journals : Article
Human health sciences : Multidisciplinary, general & others
Multinational study in children and adolescents with newly diagnosed type 1 diabetes: Association of age, ketoacidosis, HLA status, and autoantibodies on residual beta-cell function and glycemic control 12 months after diagnosis
Mortensen, H. B. [Department of Pediatrics, Glostrup University Hospital, Glostrup, Denmark]
Swift, P. G. [Leicester Royal Infirmary Children's Hospital, Leicester, United Kingdom]
Holl, R. W. [University of Ulm, Ulm, Germany]
Hougaard, P. [Department of Statistics, University of Southern Denmark, Odense, Denmark]
Hansen, L. [Department of Pediatrics, Glostrup University Hospital, Glostrup, Denmark]
Bjoerndalen, H. [Department of Pediatrics, Ulleval University Hospital, Oslo, Norway]
De Beaufort, Carine mailto [University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) >]
Knip, M. [Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland]
Pediatric Diabetes
[en] C-peptide ; Pancreatic autoantibodies ; Partial remission phase ; Residual beta-cell function ; C peptide ; HLA typing ; Adolescent ; Autoantibodies ; C-Peptide ; Child ; Child, Preschool ; Diabetes Mellitus, Type 1 ; Diabetic Ketoacidosis ; Female ; Glutamate Decarboxylase ; Hemoglobin A, Glycosylated ; HLA Antigens ; Humans ; Hypoglycemic Agents ; Infant ; Insulin ; Insulin Antibodies ; Insulin-Secreting Cells ; Male ; Multicenter Studies as Topic ; Prospective Studies ; Treatment Outcome
[en] Objective: To identify predictors of residual beta-cell function and glycemic control during the first 12 months after the diagnosis of type 1 diabetes (T1D).Subjects and Methods: Clinical information and blood samples were collected from 275 children. HbA1c, antibodies, HLA typing and mixed meal-stimulated C-peptide levels 1, 6, and 12 months after diagnosis were analyzed centrally.Results: Mean age at diagnosis was 9.1 yr. DKA with standard bicarbonate <15 mmol/L was associated with significantly poorer residual beta-cell function 1 (p = 0.004) and 12 months (p = 0.0003) after diagnosis. At 12 months, the decline in stimulated C-peptide levels compared with the levels at 1 month was 69% in the youngest age group and 50% in patients 10 yr and above (p < 0.001). Stimulated C-peptide at 12 months was predicted by younger age (p < 0.02) and bicarbonate levels at diagnosis (p = 0.005), and by stimulated C-peptide (p < 0.0001), postmeal blood glucose (p = 0.0004), insulin antibodies (IA; p = 0.02) and glutamic acid decarboxylase antibodies (GADA; p = 0.0004) at 1 month. HbA1c at 12 months was predicted by HbA1c at diagnosis (p < 0.0001), GADA at 1 month (p = 0.01), and non-white Caucasian ethnicity (p = 0.002).Conclusions: Younger age, ketoacidosis at diagnosis, and IA and GADA 1 month after diagnosis were the strongest explanatory factors for residual beta-cell function at 12 months. Glycemic control at 12 months was influenced predominantly by ethnicity, HbA1c at diagnosis, and GADA at 1 month. © 2009 John Wiley & Sons A/S.

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