Influence of the occurrence and duration of partial remission on short-term metabolic control in type 1 diabetes: the DIABHONEY pediatric study

Author:

Boutsen Laure1,Costenoble Elise1,Pollé Olivier12,Erdem Kezban1,Bugli Céline3,Lysy Philippe A.42ORCID

Affiliation:

1. Pediatric Endocrinology Unit, Cliniques universitaires Saint Luc, Bruxelles, Belgium

2. Pôle PEDI, Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium

3. Pôle Epidémiologie et Biostatistique, Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium

4. Pediatric Endocrinology Unit, Cliniques universitaires Saint Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium

Abstract

Objective: To evaluate the residual effect of partial remission (PR) on immediate post-PR glycemic control according to its occurrence and duration in a cohort of children with type 1 diabetes mellitus (T1DM). Patients and Methods: Values of glycemic control parameters [i.e. HbA1C, insulin dose–adjusted hemoglobin A1C (IDAA1C), glycemic target–adjusted HbA1C (GTAA1C)] and data from glucose monitoring devices from 189 pediatric patients with new-onset type 1 diabetes were collected retrospectively from 24 months. Patients were characterized according to their remission status (PR+ and PR). PR+ patients were subdivided into three subgroups regarding PR duration [i.e. short (⩾3–⩽6 months), intermediate (>6–⩽12 months), and long PR (>12–⩽14 months)]. We compared glycemic control data from each PR+ subgroup at +6 and +12 months post-PR with PR patients at the same postdiagnosis time. Second, PR+ subgroups were compared with each other. Results: PR+ patients showed improved glycemic control (i.e. HbA1C, IDAA1C, and GTAA1C) at + 6 months post-PR when compared with nonremitters (PR), independently of the PR duration subgroups (p < 0.05). Interestingly, patients in long PR+ subgroup exhibited higher positive residual effect than short PR+ subgroup with lower GTAA1C scores (p = 0.02), better time in range (TIR) (p = 0.003), less time in hypoglycemia (10.45 versus 16.13%, p = 0.03) and less glycemic variability (83.1 mg/dl versus 98.84 mg/dl, p = 0.03). No significant differences were found for glucose control between PR+ and PR patients at +12 months post-PR. Conclusion: This study supports the positive impact of PR occurrence and duration on short-term metabolic control (better HbA1C levels, IDAA1C and GTAA1C scores, TIR, and less glycemic variability) with the residual effect increasing according to PR duration.

Funder

Fonds De La Recherche Scientifique - FNRS

Belgian Society for Pediatric Endocrinology and Diabetology

Publisher

SAGE Publications

Subject

Endocrinology, Diabetes and Metabolism

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