Freja C B Mørk1,2, Jens Otto B Madsen2, Andreas K Jensen3, Gerrit V Hall4,5, Kasper A Pilgaard2,6, Flemming Pociot1,7, Jesper Johannesen2,7. 1. Department of Clinical Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark. 2. Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark. 3. Department of Public Health, University of Copenhagen, Biostatistics, Copenhagen, Denmark. 4. Faculty of Health and Medical Sciences, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark. 5. Clinical Metabolomics Core Facility, Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. 6. Department of Paediatrics and Adolescent Medicine, Nordsjaellands Hospital, Hillerød, Denmark. 7. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Abstract
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 IDAA1c (HbA1c (%) + 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.
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 IDAA1c (HbA1c (%) + 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.
Authors: Benjamin Udoka Nwosu; Sadichchha Parajuli; Gabrielle Jasmin; Jody Fleshman; Rohit B Sharma; Laura C Alonso; Austin F Lee; Bruce A Barton Journal: J Endocr Soc Date: 2021-11-26
Authors: Mei Shi; Xiaolin Ji; Yuting Xie; Ting Zhong; Rong Tang; Li Fan; Xia Li Journal: Front Endocrinol (Lausanne) Date: 2022-07-19 Impact factor: 6.055