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Residual beta-cell function in diabetes children followed and diagnosed in the TEDDY study compared to community controls.
Pediatr. Diabetes 18, 794-802 (2017)
ObjectiveTo explore whether children diagnosed with type 1 diabetes during islet autoantibody surveillance through The Environmental Determinants of Diabetes in the Young (TEDDY) study retain greater islet function than children diagnosed through the community. Methods TEDDY children identified at birth with high-risk human leukocyte antigen and followed every 3months until diabetes diagnosis were compared to age-matched children diagnosed with diabetes in the community. Both participated in long-term follow up after diagnosis. Hemoglobin A1c (HbA1c) and mixed meal tolerance test were performed within 1month of diabetes onset, then at 3, 6, and 12months, and biannually thereafter. ResultsComparison of 43 TEDDY and 43 paired control children showed that TEDDY children often had no symptoms (58%) at diagnosis and none had diabetic ketoacidosis (DKA) compared with 98% with diabetes symptoms and 14% DKA in the controls (P<0.001 and P=0.03, respectively). At diagnosis, mean HbA1c was lower in TEDDY (6.8%, 51mmol/mol) than control (10.5%, 91mmol/mol) children (P<0.0001). TEDDY children had significantly higher area under the curve and peak C-peptide values than the community controls throughout the first year postdiagnosis. Total insulin dose and insulin dose-adjusted A1c were lower throughout the first year postdiagnosis for TEDDY compared with control children. ConclusionsHigher C-peptide levels in TEDDY vs community-diagnosed children persist for at least 12months following diabetes onset and appear to represent a shift in the disease process of about 6months. Symptom-free diagnosis, reduction of DKA, and the potential for immune intervention with increased baseline C-peptide may portend additional long-term benefits of early diagnosis.
Impact Factor
Scopus SNIP
Web of Science
Times Cited
Times Cited
Scopus
Cited By
Cited By
Altmetric
4.267
1.594
18
21
Anmerkungen
Besondere Publikation
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Hba1c ; Pediatric Diabetes ; Preservation Of C-peptide ; Prospective Study ; Type 1 Diabetes; Glutamic-acid Decarboxylase; C-peptide; Environmental Determinants; Islet Autoantibodies; Complications Trial; Partial Remission; Type-1; Ketoacidosis; Onset; Young
Sprache
englisch
Veröffentlichungsjahr
2017
HGF-Berichtsjahr
2017
ISSN (print) / ISBN
1399-543X
e-ISSN
1399-5448
Zeitschrift
Pediatric Diabetes
Quellenangaben
Band: 18,
Heft: 8,
Seiten: 794-802
Verlag
Wiley
Verlagsort
Hoboken
Begutachtungsstatus
Peer reviewed
Institut(e)
Institute of Diabetes Research (IDF)
POF Topic(s)
30201 - Metabolic Health
90000 - German Center for Diabetes Research
90000 - German Center for Diabetes Research
Forschungsfeld(er)
Helmholtz Diabetes Center
PSP-Element(e)
G-502100-001
G-501900-021
G-501900-021
WOS ID
WOS:000415012600017
Scopus ID
85011604859
PubMed ID
28127835
Erfassungsdatum
2017-11-28