Differences in insulin sensitivity in the partial remission phase of childhood type 1 diabetes; a longitudinal cohort study.

Autor: Mørk FCB; Department of Clinical Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark., Madsen JOB; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark., Jensen AK; Department of Public Health, University of Copenhagen, Biostatistics, Copenhagen, Denmark., Hall GV; Faculty of Health and Medical Sciences, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.; Clinical Metabolomics Core Facility, Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Pilgaard KA; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark.; Department of Paediatrics and Adolescent Medicine, Nordsjaellands Hospital, Hillerød, Denmark., Pociot F; Department of Clinical Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Johannesen J; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Diabetic medicine : a journal of the British Diabetic Association [Diabet Med] 2022 Feb; Vol. 39 (2), pp. e14702. Date of Electronic Publication: 2021 Oct 06.
DOI: 10.1111/dme.14702
Abstrakt: Aims: Studies suggest that type 1 diabetes (T1D) contributes to impaired insulin sensitivity (IS). Most children with T1D experience partial remission but the knowledge regarding the magnitude and implications of impaired IS in this phase is limited. Therefore, we investigate the impact of IS on the partial remission phase.
Methods: In a longitudinal study of children and adolescents, participants were seen at three clinical visits during the first 14.5 months after diagnosis of T1D. Partial remission was defined as IDAA 1c (HbA 1c (%) + 4*daily insulin dose) ≤ 9. Beta-cell function was considered significant by a stimulated c-peptide > 300 pmol/L. Participants were characterized by (i) remission or non-remission and (ii) stimulated c-peptide levels above or below 300 pmol/L. IS, body mass index (BMI), total body fat, sex, age, pubertal status and ketoacidosis at onset were compared.
Results: Seventy-eight children and adolescents aged 3.3-17.7 years were included. At 14.5 months post-diagnosis, 54.5% of the participants with stimulated c-peptide > 300 pmol/L were not in partial remission. Participants not in remission had significant lower IS 2.5 (p = 0.032), and 14.5 (p = 0.022) months after diagnosis compared to participants in partial remission with similar c-peptide levels. IS did not fluctuate during the remission phase.
Conclusions: A number of children and adolescents have impaired IS in the remission phase of paediatric T1D and are not in remission 14.5 months after diagnosis despite stimulated c-peptide > 300 pmol/L.
(© 2021 Diabetes UK.)
Databáze: MEDLINE
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