Partial remission in type 1 diabetes and associated factors: Analysis based on the insulin dose‐adjusted hemoglobin A1c in children and adolescents from a regional diabetes center, Auckland, New Zealand

2019 ◽  
Vol 20 (7) ◽  
pp. 892-900
Author(s):  
Valentina Chiavaroli ◽  
José G. B. Derraik ◽  
Muhammad Y. Jalaludin ◽  
Benjamin B. Albert ◽  
Selvarajan Ramkumar ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
New Zealand ◽  
Children And Adolescents ◽  
Partial Remission ◽  
Associated Factors ◽  
Hemoglobin A1c ◽  
Insulin Dose ◽  
Factors Analysis ◽  
Diabetes Center

Partial remission in children and adolescents with type 1 diabetes: an analysis based on the insulin dose-adjusted hemoglobin A1c

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emine Ayça Cimbek ◽  
Aydın Bozkır ◽  
Deniz Usta ◽  
Nazım Ercüment Beyhun ◽  
Ayşenur Ökten ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Partial Remission ◽  
Hemoglobin A1c ◽  
Insulin Dose ◽  
Age At Onset ◽  
Insulin Requirement ◽  
C Peptide ◽  
Factors Associated ◽  
Daily Insulin

Abstract Objectives Most patients with type 1 diabetes (T1D) experience a transient phase of partial remission (PR). This study aimed to identify the demographic and clinical factors associated with PR. Methods This was a longitudinal retrospective cohort study of 133 children and adolescents with T1D. PR was defined by the gold standard insulin dose-adjusted hemoglobin A1c (HbA1c) (IDAA1c) of ≤9. Results Remission was observed in 77 (57.9%) patients. At diagnosis, remitters had significantly higher pH (7.3 ± 0.12 vs. 7.23 ± 0.15, p=0.003), higher C-peptide levels (0.45 ± 0.31 ng/mL vs. 0.3 ± 0.22, p=0.003), and they were significantly older (9.3 ± 3.6 years vs. 7.3 ± 4.2, p=0.008) compared with non-remitters. PR developed more frequently in patients without diabetic ketoacidosis (DKA) (p=0.026) and with disease onset after age 5 (p=0.001). Patients using multiple daily insulin regimen were more likely to experience PR than those treated with a twice daily regimen (63.9 vs. 32%, p=0.004). Only age at onset was an independent predictor of PR (OR: 1.12, 95% CI: 1-1.25; p=0.044). Remitters had lower HbA1c levels and daily insulin requirement from diagnosis until one year after diagnosis (p<0.001). PR recurred in 7 (9%) patients. The daily insulin requirement at three months was lower in remitters with PR recurrence compared to those without (0.23 ± 0.14 vs. 0.4 ± 0.17 U/kg/day, p=0.014). Conclusions Addressing factors associated with the occurrence of PR could provide a better comprehension of metabolic control in T1D. The lack of DKA and higher C-peptide levels may influence PR, but the main factor associated with PR presence was older age at onset. PR may recur in a small proportion of patients.

Factors contributing to partial remission in type 1 diabetes: analysis based on the insulin dose-adjusted HbA1c in 3657 children and adolescents from Germany and Austria

2016 ◽  
Vol 18 (6) ◽  
pp. 428-434 ◽  
Author(s):  
Katrin Nagl ◽  
Julia M. Hermann ◽  
Michaela Plamper ◽  
Carmen Schröder ◽  
Axel Dost ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Partial Remission ◽  
Insulin Dose

scholarly journals Proinsulin, GLP-1, and glucagon are associated with partial remission in children and adolescents with newly diagnosed type 1 diabetes

2011 ◽  
Vol 13 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Anne Kaas ◽  
Marie Louise Max Andersen ◽  
Siri Fredheim ◽  
Philip Hougaard ◽  
Karsten Buschard ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Partial Remission ◽  
Newly Diagnosed

scholarly journals Glucose Control, Disease Burden, and Educational Gaps in People With Type 1 Diabetes: Exploratory Study of an Integrated Mobile Diabetes App (Preprint)

2017 ◽  
Author(s):  
Cornelis J Tack ◽  
Gerardus J Lancee ◽  
Barend Heeren ◽  
Lucien JLPG Engelen ◽  
Sandra Hendriks ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Control ◽  
Exploratory Study ◽  
Disease Burden ◽  
Hemoglobin A1c ◽  
Insulin Dose ◽  
Diabetes Control ◽  
Self Management ◽  
Scale Scores

BACKGROUND Self-monitoring and self-management, crucial for optimal glucose control in type 1 diabetes, requires many disease-related decisions per day and imposes a substantial disease burden on people with diabetes. Innovative technologies that integrate relevant measurements may offer solutions that support self-management, decrease disease burden, and benefit diabetes control. OBJECTIVE The objective of our study was to evaluate a prototype integrated mobile phone diabetes app in people with type 1 diabetes. METHODS In this exploratory study, we developed an app that contained cloud-stored log functions for glucose, carbohydrates (including a library), insulin, planned exercise, and mood, combined with a bolus calculator and communication functions. Adults with diabetes tested the app for 6 weeks. We assessed the feasibility of app use, user experiences, perceived disease burden (through questionnaires), insulin dose and basal to bolus ratio, mean glucose level, hemoglobin A1c, and number of hypoglycemic events. RESULTS A total of 19 participants completed the study, resulting in 5782 data entries. The most frequently used feature was logging blood glucose, insulin, and carbohydrates. Mean diabetes-related emotional problems (measured with the Problem Areas in Diabetes scale) scores decreased from 14.4 (SD 10.0) to 12.2 (SD 10.3; P=.04), and glucose control improved, with hemoglobin A1c decreasing from 7.9% (mean 62.3, SD 8 mmol/mol) to 7.6% (mean 59.8, SD 7 mmol/mol; P=.047). The incidence of hypoglycemic events did not change. Participants were generally positive about the app, rating it as “refreshing,” and as providing structure by reinforcing insulin-dosing principles. The app revealed substantial knowledge gaps. Logged data enabled additional detailed analyses. CONCLUSIONS An integrated mobile diabetes app has the potential to improve diabetes self-management and provide tailored educational support, which may decrease disease burden and benefit diabetes control.

Safety and metabolic impact of Ramadan fasting in children and adolescents with type 1 diabetes

2016 ◽  
Vol 29 (5) ◽  
Author(s):  
Amany El-Hawary ◽  
Nanees Salem ◽  
Ashraf Elsharkawy ◽  
Abdelhameed Metwali ◽  
Alaa Wafa ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Insulin Dose ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Regular Insulin ◽  
Insulin Regimen ◽  
Premixed Insulin ◽  
Ramadan Fasting

AbstractAnnually, many children and adolescents with type 1 diabetes mellitus (T1DM) insist on fasting for Ramadan despite being exempted and despite knowing all the risks. We aimed to assess the safety and metabolic impact of Ramadan fasting in children with T1DM using different insulin regimens.Children with T1DM who choose to fast during Ramadan 1434/2013 (29 days) were recruited 3 months before Ramadan. They received pre-Ramadan intensive education. Three insulin regimens were included; Regimen-I (regular insulin/NPH); Regimen-II (regular insulin/insulin glargine) and Regimen-III (premixed insulin). Changes in weight, insulin dose, HbAOut of total 53 patients (24 male), 28 patients (52.8%) completed Ramadan fasting (fasting group). The remaining 25 patients were included in (broke-fasting group). Positive correlation between fructosamine changes and number of days fasted during Ramadan. Significant decrease in post-Ramadan fructosamine (<0.001) and increase in post-Ramadan total cholesterol and low density lipoprotein (LDL) levels were detected within fasting, broke-fasting and insulin regimen groups. Significant higher blood glucose at three time points, pre-Iftar, pre-Sohur and midday in Regimen-I compared to Regimen-II and Regimen-III (p=0.004).: Fasting during Ramadan is feasible and is associated with significant improvement in fructosamine level in children with T1DM using different insulin regimens. Mandatory consideration to the quality and quantity of food offered to patients with T1DM during Ramadan to guard against adverse changes in lipid profile.

Insulin glargine improves hemoglobin A1c in children and adolescents with poorly controlled type 1 diabetes

2003 ◽  
Vol 4 (2) ◽  
pp. 64-69 ◽  
Author(s):  
Anne Jackson ◽  
Christine Ternand ◽  
Carol Brunzell ◽  
Teresa Kleinschmidt ◽  
Dawn Dew ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Glargine ◽  
Children And Adolescents ◽  
Hemoglobin A1c
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