Reduced morbidity at diagnosis and improved glycemic control in children previously enrolled in DiPiS follow‐up. Issue 7 (13th May 2014)

• Record Type: Journal Article
• Authors: Lundgren, Markus; Sahlin, Åsa; Svensson, Camilla; Carlsson, Annelie; Cedervall, Elisabeth; Jönsson, Björn; Jönsson, Ida; Larsson, Karin; Lernmark, Åke; Neiderud, Jan; Vigård, Tore; Elding Larsson, Helena; the DiPiS study group
• Is Part Of: Pediatric diabetes. Volume 15:Issue 7(2014:Nov.)
• Page Start: 494
• Page End: 501
• Publication Date: 2014-05-13
• Subjects: Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.12151
• Languages: English
• ISSNs: 1399-543X

Abstract

<abstract abstract-type="main" id="pedi12151-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="pedi12151-sec-0001" sec-type="section"> <title>Aims/hypothesis</title> <p id="pedi12151-para-0001">Children participating in longitudinal type 1 diabetes prediction studies were reported to have less severe disease at diabetes diagnosis. Our aim was to investigate children who from birth participated in the Diabetes Prediction in Skåne (DiPiS) study for metabolic status at diagnosis and then continued to be followed for 2 yr of regular clinical care.</p> </sec> <sec id="pedi12151-sec-0002" sec-type="section"> <title>Methods</title> <p id="pedi12151-para-0002">Children, followed in DiPiS before diagnosis, were compared to children in the same birth cohort, who did not participate in follow‐up. Metabolic status, symptoms at diagnosis as well as hemoglobin A1c (HbA1c) and doses of insulin at 3, 6, 12, and 24 months after diagnosis were compared.</p> </sec> <sec id="pedi12151-sec-0003" sec-type="section"> <title>Results</title> <p id="pedi12151-para-0003">Children, followed in DiPiS and diagnosed at 2–12 yr of age, had 0.8% (9 mmol/mol) lower HbA1c at diagnosis than those who were not followed (p = 0.006). At diagnosis, fewer DiPiS children had symptoms (p = 0.014) and ketoacidosis at diagnosis were reduced (2% compared to 18%, p = 0.005). During regular clinical care, HbA1c levels for the DiPiS children remained lower both at 12 (0.4% (4 mmol/mol); p = 0.009) and 24 months (0.8% (9 mmol/mol) p < 0.001) after diagnosis, despite no difference in total daily insulin between the two groups.</p> </sec> <sec id="pedi12151-sec-0004" sec-type="section"> <title>Conclusions</title> <p id="pedi12151-para-0004">Participation in prospective follow‐up before diagnosis of type 1 diabetes leads to earlier diagnosis with fewer symptoms, decreased incidence of ketoacidosis as well as better metabolic control up to 2 yr after diagnosis. Our data indicate that metabolic control at the time of diabetes diagnosis is important for early metabolic control possibly affecting the risk of long‐term complications.</p> </sec> </abstract>