Effect of screening for type 1 diabetes on early metabolic control: the DiPiS study
Aims/hypothesis It has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes diagnosis. The aim of this study was to analyse glycaemic control over a longer period, past the period of partial remission, after diagnosis...
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| Veröffentlicht in: | Diabetologia Jg. 62; H. 1; S. 53 - 57 |
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| Format: | Journal Article |
| Sprache: | Englisch |
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Berlin/Heidelberg
Springer Berlin Heidelberg
01.01.2019
Springer Nature B.V |
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| ISSN: | 0012-186X, 1432-0428, 1432-0428 |
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| Abstract | Aims/hypothesis
It has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes diagnosis. The aim of this study was to analyse glycaemic control over a longer period, past the period of partial remission, after diagnosis in children followed before diagnosis in the Swedish Diabetes Prediction in Skåne (DiPiS) study compared with children of equal age not enrolled in pre-diabetes follow-up, receiving equivalent diabetes care.
Methods
HbA
1c
from diagnosis and for the following 5 years, as well as differences in insulin dosage, BMI, pump use, partial remission according to insulin dose-adjusted HbA
1c
and baseline demographics were compared between children who were enrolled in follow-up and had received information on diabetes risk (
n
= 51) and children not enrolled in follow-up (
n
= 78).
Results
The group followed before diagnosis had a higher proportion of first-degree relatives (FDRs) with diabetes (28% vs 5.6%;
p
= 0.001) and a higher proportion of participants with mothers born in Sweden (100% vs 89%;
p
= 0.02). No significant differences in total daily insulin dose, pump use or other baseline sociodemographic factors were detected between the groups. Median HbA
1c
at diagnosis and at 1, 2, 3, 4 and 5 years after diabetes diagnosis was significantly lower in children followed before diagnosis (all
p
< 0.05), and was not related to FDR status.
Conclusions/interpretation
Compared with controls not previously enrolled in follow-up, our study shows that children enrolled in longitudinal follow-up before the diagnosis of diabetes have better glycaemic control, measured by HbA
1c
, up to 5 years after diagnosis and during the initial period of partial remission. Improved glycaemic control in the initial years of living with type 1 diabetes could affect long-term outcome and complications and might also improve study enrolment in future longitudinal studies. |
|---|---|
| AbstractList | Aims/hypothesisIt has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes diagnosis. The aim of this study was to analyse glycaemic control over a longer period, past the period of partial remission, after diagnosis in children followed before diagnosis in the Swedish Diabetes Prediction in Skåne (DiPiS) study compared with children of equal age not enrolled in pre-diabetes follow-up, receiving equivalent diabetes care.MethodsHbA1c from diagnosis and for the following 5 years, as well as differences in insulin dosage, BMI, pump use, partial remission according to insulin dose-adjusted HbA1c and baseline demographics were compared between children who were enrolled in follow-up and had received information on diabetes risk (n = 51) and children not enrolled in follow-up (n = 78).ResultsThe group followed before diagnosis had a higher proportion of first-degree relatives (FDRs) with diabetes (28% vs 5.6%; p = 0.001) and a higher proportion of participants with mothers born in Sweden (100% vs 89%; p = 0.02). No significant differences in total daily insulin dose, pump use or other baseline sociodemographic factors were detected between the groups. Median HbA1c at diagnosis and at 1, 2, 3, 4 and 5 years after diabetes diagnosis was significantly lower in children followed before diagnosis (all p < 0.05), and was not related to FDR status.Conclusions/interpretationCompared with controls not previously enrolled in follow-up, our study shows that children enrolled in longitudinal follow-up before the diagnosis of diabetes have better glycaemic control, measured by HbA1c, up to 5 years after diagnosis and during the initial period of partial remission. Improved glycaemic control in the initial years of living with type 1 diabetes could affect long-term outcome and complications and might also improve study enrolment in future longitudinal studies. It has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes diagnosis. The aim of this study was to analyse glycaemic control over a longer period, past the period of partial remission, after diagnosis in children followed before diagnosis in the Swedish Diabetes Prediction in Skåne (DiPiS) study compared with children of equal age not enrolled in pre-diabetes follow-up, receiving equivalent diabetes care. HbA from diagnosis and for the following 5 years, as well as differences in insulin dosage, BMI, pump use, partial remission according to insulin dose-adjusted HbA and baseline demographics were compared between children who were enrolled in follow-up and had received information on diabetes risk (n = 51) and children not enrolled in follow-up (n = 78). The group followed before diagnosis had a higher proportion of first-degree relatives (FDRs) with diabetes (28% vs 5.6%; p = 0.001) and a higher proportion of participants with mothers born in Sweden (100% vs 89%; p = 0.02). No significant differences in total daily insulin dose, pump use or other baseline sociodemographic factors were detected between the groups. Median HbA at diagnosis and at 1, 2, 3, 4 and 5 years after diabetes diagnosis was significantly lower in children followed before diagnosis (all p < 0.05), and was not related to FDR status. Compared with controls not previously enrolled in follow-up, our study shows that children enrolled in longitudinal follow-up before the diagnosis of diabetes have better glycaemic control, measured by HbA , up to 5 years after diagnosis and during the initial period of partial remission. Improved glycaemic control in the initial years of living with type 1 diabetes could affect long-term outcome and complications and might also improve study enrolment in future longitudinal studies. It has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes diagnosis. The aim of this study was to analyse glycaemic control over a longer period, past the period of partial remission, after diagnosis in children followed before diagnosis in the Swedish Diabetes Prediction in Skåne (DiPiS) study compared with children of equal age not enrolled in pre-diabetes follow-up, receiving equivalent diabetes care.AIMS/HYPOTHESISIt has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes diagnosis. The aim of this study was to analyse glycaemic control over a longer period, past the period of partial remission, after diagnosis in children followed before diagnosis in the Swedish Diabetes Prediction in Skåne (DiPiS) study compared with children of equal age not enrolled in pre-diabetes follow-up, receiving equivalent diabetes care.HbA1c from diagnosis and for the following 5 years, as well as differences in insulin dosage, BMI, pump use, partial remission according to insulin dose-adjusted HbA1c and baseline demographics were compared between children who were enrolled in follow-up and had received information on diabetes risk (n = 51) and children not enrolled in follow-up (n = 78).METHODSHbA1c from diagnosis and for the following 5 years, as well as differences in insulin dosage, BMI, pump use, partial remission according to insulin dose-adjusted HbA1c and baseline demographics were compared between children who were enrolled in follow-up and had received information on diabetes risk (n = 51) and children not enrolled in follow-up (n = 78).The group followed before diagnosis had a higher proportion of first-degree relatives (FDRs) with diabetes (28% vs 5.6%; p = 0.001) and a higher proportion of participants with mothers born in Sweden (100% vs 89%; p = 0.02). No significant differences in total daily insulin dose, pump use or other baseline sociodemographic factors were detected between the groups. Median HbA1c at diagnosis and at 1, 2, 3, 4 and 5 years after diabetes diagnosis was significantly lower in children followed before diagnosis (all p < 0.05), and was not related to FDR status.RESULTSThe group followed before diagnosis had a higher proportion of first-degree relatives (FDRs) with diabetes (28% vs 5.6%; p = 0.001) and a higher proportion of participants with mothers born in Sweden (100% vs 89%; p = 0.02). No significant differences in total daily insulin dose, pump use or other baseline sociodemographic factors were detected between the groups. Median HbA1c at diagnosis and at 1, 2, 3, 4 and 5 years after diabetes diagnosis was significantly lower in children followed before diagnosis (all p < 0.05), and was not related to FDR status.Compared with controls not previously enrolled in follow-up, our study shows that children enrolled in longitudinal follow-up before the diagnosis of diabetes have better glycaemic control, measured by HbA1c, up to 5 years after diagnosis and during the initial period of partial remission. Improved glycaemic control in the initial years of living with type 1 diabetes could affect long-term outcome and complications and might also improve study enrolment in future longitudinal studies.CONCLUSIONS/INTERPRETATIONCompared with controls not previously enrolled in follow-up, our study shows that children enrolled in longitudinal follow-up before the diagnosis of diabetes have better glycaemic control, measured by HbA1c, up to 5 years after diagnosis and during the initial period of partial remission. Improved glycaemic control in the initial years of living with type 1 diabetes could affect long-term outcome and complications and might also improve study enrolment in future longitudinal studies. Aims/hypothesis It has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes diagnosis. The aim of this study was to analyse glycaemic control over a longer period, past the period of partial remission, after diagnosis in children followed before diagnosis in the Swedish Diabetes Prediction in Skåne (DiPiS) study compared with children of equal age not enrolled in pre-diabetes follow-up, receiving equivalent diabetes care. Methods HbA 1c from diagnosis and for the following 5 years, as well as differences in insulin dosage, BMI, pump use, partial remission according to insulin dose-adjusted HbA 1c and baseline demographics were compared between children who were enrolled in follow-up and had received information on diabetes risk ( n = 51) and children not enrolled in follow-up ( n = 78). Results The group followed before diagnosis had a higher proportion of first-degree relatives (FDRs) with diabetes (28% vs 5.6%; p = 0.001) and a higher proportion of participants with mothers born in Sweden (100% vs 89%; p = 0.02). No significant differences in total daily insulin dose, pump use or other baseline sociodemographic factors were detected between the groups. Median HbA 1c at diagnosis and at 1, 2, 3, 4 and 5 years after diabetes diagnosis was significantly lower in children followed before diagnosis (all p < 0.05), and was not related to FDR status. Conclusions/interpretation Compared with controls not previously enrolled in follow-up, our study shows that children enrolled in longitudinal follow-up before the diagnosis of diabetes have better glycaemic control, measured by HbA 1c , up to 5 years after diagnosis and during the initial period of partial remission. Improved glycaemic control in the initial years of living with type 1 diabetes could affect long-term outcome and complications and might also improve study enrolment in future longitudinal studies. Aims/hypothesis: It has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes diagnosis. The aim of this study was to analyse glycaemic control over a longer period, past the period of partial remission, after diagnosis in children followed before diagnosis in the Swedish Diabetes Prediction in Skåne (DiPiS) study compared with children of equal age not enrolled in pre-diabetes follow-up, receiving equivalent diabetes care. Methods: HbA1c from diagnosis and for the following 5 years, as well as differences in insulin dosage, BMI, pump use, partial remission according to insulin dose-adjusted HbA1c and baseline demographics were compared between children who were enrolled in follow-up and had received information on diabetes risk (n = 51) and children not enrolled in follow-up (n = 78). Results: The group followed before diagnosis had a higher proportion of first-degree relatives (FDRs) with diabetes (28% vs 5.6%; p = 0.001) and ahigher proportion of participants with mothers born in Sweden (100% vs 89%; p = 0.02). No significant differences in total daily insulin dose, pump use or other baseline sociodemographic factors were detected between the groups. Median HbA1c at diagnosis and at 1, 2, 3, 4 and 5 years after diabetes diagnosis was significantly lower in children followed before diagnosis (all p < 0.05), and was not related to FDR status. Conclusions/interpretation: Compared with controls not previously enrolled in follow-up, our study shows that children enrolled in longitudinal follow-up before the diagnosis of diabetes have better glycaemic control, measured by HbA1c, up to 5 years after diagnosis and during the initial period of partial remission. Improved glycaemic control in the initial years of living with type 1 diabetes could affect long-term outcome and complications and might also improve study enrolment in future longitudinal studies. |
| Author | Jonsdottir, Berglind Lundgren, Markus Elding Larsson, Helena |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30109365$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1111/pedi.12208 10.2337/dc11-1026 10.1111/j.1399-5448.2011.00829.x 10.1016/j.diabres.2018.03.057 10.1111/pedi.12674 10.2337/diacare.27.6.1399 10.1111/pedi.12151 10.2337/dc17-0558 10.1016/0140-6736(93)91215-8 10.1111/pedi.12485 |
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| Copyright | The Author(s) 2018 Diabetologia is a copyright of Springer, (2018). All Rights Reserved. © 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| CorporateAuthor | for the DiPiS study group DiPiS study group Lunds universitet Profile areas and other strong research environments Department of Clinical Sciences, Malmö Lund University Strategiska forskningsområden (SFO) EXODIAB: Excellence of Diabetes Research in Sweden Faculty of Medicine Strategic research areas (SRA) Medicinska fakulteten Pediatrisk endokrinologi Profilområden och andra starka forskningsmiljöer Institutionen för kliniska vetenskaper, Malmö Paediatric Endocrinology |
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| Keywords | Screening Longitudinal studies Type 1 diabetes Metabolic control |
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| PublicationSubtitle | Clinical, Translational and Experimental Diabetes and Metabolism |
| PublicationTitle | Diabetologia |
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| References | LundgrenMSahlinÅSvenssonCReduced morbidity at diagnosis and improved glycemic control in children previously enrolled in DiPiS follow-upPediatr Diabetes2014154945011:CAS:528:DC%2BC2cXhs1yis7fM10.1111/pedi.12151248238164190091 Winkler C, Schober E, Ziegler A-G, Holl RW (2012) Markedly reduced rate of diabetic ketoacidosis at onset of type 1 diabetes in relatives screened for islet autoantibodies. 13:308–313 Max AndersenMLCHougaardPPörksenSPartial Remission Definition: validation based on the insulin dose-adjusted HbA1c (IDAA1C) in 129 Danish Children with New-Onset Type 1 DiabetesPediatr Diabetes2014154694761:CAS:528:DC%2BC2cXhs1yis7bF10.1111/pedi.1220825287319 Steck AK, Larsson HE, Liu X, et al (2017) Residual beta-cell function in diabetes children followed and diagnosed in the TEDDY study compared to community controls Larsson HE, Vehik KK, Gesualdo P et al (2013) Children followed in the TEDDY study are diagnosed with type 1 diabetes at an early stage of disease. 15:118–126 Smith LB, Liu X, Johnson SB et al (2018) Family adjustment to diabetes diagnosis in children: can participation in a study on type 1 diabetes genetic risk be helpful? Pediatr Diabetes 19:1025–1033 DucaLMWangBRewersMRewersADiabetic ketoacidosis at diagnosis of type 1 diabetes predicts poor long-term glycemic controlDiabetes Care201740124912551:CAS:528:DC%2BC1cXitVShsbbE10.2337/dc17-055828667128 Elding LarssonHVehikKVehikKKReduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-upDiabetes Care2011342347235210.2337/dc11-1026219724093198296 KellerRJEisenbarthGSJacksonRAInsulin prophylaxis in individuals at high risk of type I diabetesLancet19933419279281:STN:280:DyaK3s3htFajtg%3D%3D10.1016/0140-6736(93)91215-88096268 PerssonMBeckerCElding LarssonHThe Better Diabetes Diagnosis (BDD) study - a review of a nationwide prospective cohort study in SwedenDiabetes Res Clin Pract20181402362441:STN:280:DC%2BC1MnpvVCgtw%3D%3D10.1016/j.diabres.2018.03.05729626585 BarkerJMGoehrigSHBarrigaKClinical characteristics of children diagnosed with type 1 diabetes through intensive screening and follow-upDiabetes Care2004271399140410.2337/diacare.27.6.139915161795 4706_CR5 MLC Max Andersen (4706_CR8) 2014; 15 4706_CR9 JM Barker (4706_CR3) 2004; 27 4706_CR10 H Elding Larsson (4706_CR2) 2011; 34 RJ Keller (4706_CR4) 1993; 341 LM Duca (4706_CR11) 2017; 40 4706_CR1 M Persson (4706_CR7) 2018; 140 M Lundgren (4706_CR6) 2014; 15 30426167 - Diabetologia. 2019 Jan;62(1):24-27 |
| References_xml | – reference: KellerRJEisenbarthGSJacksonRAInsulin prophylaxis in individuals at high risk of type I diabetesLancet19933419279281:STN:280:DyaK3s3htFajtg%3D%3D10.1016/0140-6736(93)91215-88096268 – reference: Winkler C, Schober E, Ziegler A-G, Holl RW (2012) Markedly reduced rate of diabetic ketoacidosis at onset of type 1 diabetes in relatives screened for islet autoantibodies. 13:308–313 – reference: Steck AK, Larsson HE, Liu X, et al (2017) Residual beta-cell function in diabetes children followed and diagnosed in the TEDDY study compared to community controls – reference: DucaLMWangBRewersMRewersADiabetic ketoacidosis at diagnosis of type 1 diabetes predicts poor long-term glycemic controlDiabetes Care201740124912551:CAS:528:DC%2BC1cXitVShsbbE10.2337/dc17-055828667128 – reference: PerssonMBeckerCElding LarssonHThe Better Diabetes Diagnosis (BDD) study - a review of a nationwide prospective cohort study in SwedenDiabetes Res Clin Pract20181402362441:STN:280:DC%2BC1MnpvVCgtw%3D%3D10.1016/j.diabres.2018.03.05729626585 – reference: Max AndersenMLCHougaardPPörksenSPartial Remission Definition: validation based on the insulin dose-adjusted HbA1c (IDAA1C) in 129 Danish Children with New-Onset Type 1 DiabetesPediatr Diabetes2014154694761:CAS:528:DC%2BC2cXhs1yis7bF10.1111/pedi.1220825287319 – reference: LundgrenMSahlinÅSvenssonCReduced morbidity at diagnosis and improved glycemic control in children previously enrolled in DiPiS follow-upPediatr Diabetes2014154945011:CAS:528:DC%2BC2cXhs1yis7fM10.1111/pedi.12151248238164190091 – reference: Larsson HE, Vehik KK, Gesualdo P et al (2013) Children followed in the TEDDY study are diagnosed with type 1 diabetes at an early stage of disease. 15:118–126 – reference: Elding LarssonHVehikKVehikKKReduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-upDiabetes Care2011342347235210.2337/dc11-1026219724093198296 – reference: BarkerJMGoehrigSHBarrigaKClinical characteristics of children diagnosed with type 1 diabetes through intensive screening and follow-upDiabetes Care2004271399140410.2337/diacare.27.6.139915161795 – reference: Smith LB, Liu X, Johnson SB et al (2018) Family adjustment to diabetes diagnosis in children: can participation in a study on type 1 diabetes genetic risk be helpful? Pediatr Diabetes 19:1025–1033 – volume: 15 start-page: 469 year: 2014 ident: 4706_CR8 publication-title: Pediatr Diabetes doi: 10.1111/pedi.12208 – volume: 34 start-page: 2347 year: 2011 ident: 4706_CR2 publication-title: Diabetes Care doi: 10.2337/dc11-1026 – ident: 4706_CR1 doi: 10.1111/j.1399-5448.2011.00829.x – volume: 140 start-page: 236 year: 2018 ident: 4706_CR7 publication-title: Diabetes Res Clin Pract doi: 10.1016/j.diabres.2018.03.057 – ident: 4706_CR9 – ident: 4706_CR10 doi: 10.1111/pedi.12674 – volume: 27 start-page: 1399 year: 2004 ident: 4706_CR3 publication-title: Diabetes Care doi: 10.2337/diacare.27.6.1399 – volume: 15 start-page: 494 year: 2014 ident: 4706_CR6 publication-title: Pediatr Diabetes doi: 10.1111/pedi.12151 – volume: 40 start-page: 1249 year: 2017 ident: 4706_CR11 publication-title: Diabetes Care doi: 10.2337/dc17-0558 – volume: 341 start-page: 927 year: 1993 ident: 4706_CR4 publication-title: Lancet doi: 10.1016/0140-6736(93)91215-8 – ident: 4706_CR5 doi: 10.1111/pedi.12485 – reference: 30426167 - Diabetologia. 2019 Jan;62(1):24-27 |
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It has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes... It has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes diagnosis. The... Aims/hypothesisIt has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes... Aims/hypothesis: It has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes... |
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| SubjectTerms | Blood Glucose - metabolism Child Child, Preschool Children Clinical Medicine Demography Diabetes Diabetes mellitus Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - diagnosis Diabetes Mellitus, Type 1 - drug therapy Diagnosis Endocrinology and Diabetes Endokrinologi och diabetes Female Glycated Hemoglobin A - metabolism Human Physiology Humans Hypoglycemic Agents - therapeutic use Insulin Insulin - therapeutic use Internal Medicine Klinisk medicin Longitudinal Studies Male Medical and Health Sciences Medicin och hälsovetenskap Medicine Medicine & Public Health Metabolic Diseases Pediatrics Pediatrik Prospective Studies Remission Short Communication |
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| Title | Effect of screening for type 1 diabetes on early metabolic control: the DiPiS study |
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