Influence of Age on Partial Clinical Remission among Children with Newly Diagnosed Type 1 Diabetes

Int J Environ Res Public Health. 2020 Jul 3;17(13):4801. doi: 10.3390/ijerph17134801.

Abstract

Partial clinical remission (PCR) is a transitory period characterized by the residual endogenous insulin secretion following type 1 diabetes (T1D) diagnosis and introducing the insulin therapy. Scientific interest in PCR has been recently increasing, as this phase could be crucial to preserve functional beta cells after T1D onset, also taking advantage of new therapeutic opportunities. The aim of this study was to assess the frequency, duration and associated factors of PCR in children newly diagnosed with T1D. Our cohort study included 167 pediatric patients aged 13.8 ± 4.1 years. The association of clinical and laboratory factors with the occurrence and duration of PCR was evaluated via logistic regression and multivariable generalized linear model, respectively. PCR occurred in 63.5% of the examined patients. Patients who achieved the remission phase were significantly older, and they had lower daily insulin requirement compared with non-remitters. PCR was positively associated to body mass index (OR = 1.11; p = 0.032), pH value (OR 49.02; p = 0.003) and c-peptide levels (OR 12.8; p = 0.002). The average duration of PCR was 13.4 months, and older age at diagnosis was the only predictor factor. Two years after diagnosis remitter patients had lower HbA1c and daily insulin requirement.

Keywords: C-peptide; GADA; early diagnosis; honeymoon; length.

MeSH terms

  • Adolescent
  • Age Factors
  • Aged
  • Child
  • Cohort Studies
  • Diabetes Mellitus, Type 1*
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male
  • Remission Induction

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin