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Reduced morbidity at diagnosis and improved glycemic control in children previously enrolled in DiPiS follow-up

Lundgren, Markus LU ; Sahlin, Åsa; Svensson, Camilla; Carlsson, Annelie LU ; Cedervall, Elisabeth; Jönsson, Björn; Jönsson, Ida LU ; Larsson, Karin; Lernmark, Åke LU and Neiderud, Jan LU , et al. (2014) In Pediatric Diabetes 15(7). p.494-501
Abstract
Aims/hypothesis: 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 Skane (DiPiS) study for metabolic status at diagnosis and then continued to be followed for 2 yr of regular clinical care. Methods: 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. Results: Children, followed in DiPiS and diagnosed at 2-12 yr of age, had 0.8%... (More)
Aims/hypothesis: 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 Skane (DiPiS) study for metabolic status at diagnosis and then continued to be followed for 2 yr of regular clinical care. Methods: 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. Results: 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. Conclusions: 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. (Less)
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publication status
published
subject
keywords
diabetic ketoacidosis, follow-up studies, HbA1c, type 1 diabetes
in
Pediatric Diabetes
volume
15
issue
7
pages
494 - 501
publisher
Wiley-Blackwell
external identifiers
  • wos:000345035200004
  • scopus:84907952499
ISSN
1399-543X
DOI
10.1111/pedi.12151
language
English
LU publication?
yes
id
50fb293f-4022-48f1-8c9f-2b13c062215f (old id 4865397)
date added to LUP
2015-01-07 11:31:28
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2017-11-12 03:00:09
@article{50fb293f-4022-48f1-8c9f-2b13c062215f,
  abstract     = {Aims/hypothesis: 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 Skane (DiPiS) study for metabolic status at diagnosis and then continued to be followed for 2 yr of regular clinical care. Methods: 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. Results: 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 &lt; 0.001) after diagnosis, despite no difference in total daily insulin between the two groups. Conclusions: 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.},
  author       = {Lundgren, Markus and Sahlin, Åsa and Svensson, Camilla and Carlsson, Annelie and Cedervall, Elisabeth and Jönsson, Björn and Jönsson, Ida and Larsson, Karin and Lernmark, Åke and Neiderud, Jan and Vigård, Tore and Larsson, Helena},
  issn         = {1399-543X},
  keyword      = {diabetic ketoacidosis,follow-up studies,HbA1c,type 1 diabetes},
  language     = {eng},
  number       = {7},
  pages        = {494--501},
  publisher    = {Wiley-Blackwell},
  series       = {Pediatric Diabetes},
  title        = {Reduced morbidity at diagnosis and improved glycemic control in children previously enrolled in DiPiS follow-up},
  url          = {http://dx.doi.org/10.1111/pedi.12151},
  volume       = {15},
  year         = {2014},
}