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Hummel, S. ; Carl, J. ; Friedl, N. ; Winkler, C. ; Kick, K.* ; Stock, J. ; Reinmüller, F.* ; Ramminger, C. ; Schmidt, J.* ; Lwowsky, D.* ; Braig, S.* ; Dunstheimer, D.* ; Ermer, U.* ; Gerstl, E.M.* ; Weber, L.* ; Nellen-Hellmuth, N.* ; Brämswig, S.* ; Sindichakis, M.* ; Tretter, S.* ; Lorrmann, A.* ; Bonifacio, E. ; Ziegler, A.-G. ; Achenbach, P.

Children diagnosed with presymptomatic type 1 diabetes through public health screening have milder diabetes at clinical manifestation.

Diabetologia 66, 1633-1642 (2023)
Publ. Version/Full Text DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
Aims/hypothesis: We aimed to determine whether disease severity was reduced at onset of clinical (stage 3) type 1 diabetes in children previously diagnosed with presymptomatic type 1 diabetes in a population-based screening programme for islet autoantibodies. Methods: Clinical data obtained at diagnosis of stage 3 type 1 diabetes were evaluated in 128 children previously diagnosed with presymptomatic early-stage type 1 diabetes between 2015 and 2022 in the Fr1da study and compared with data from 736 children diagnosed with incident type 1 diabetes between 2009 and 2018 at a similar age in the DiMelli study without prior screening. Results: At the diagnosis of stage 3 type 1 diabetes, children with a prior early-stage diagnosis had lower median HbA1c (51 mmol/mol vs 91 mmol/mol [6.8% vs 10.5%], p<0.001), lower median fasting glucose (5.3 mmol/l vs 7.2 mmol/l, p<0.05) and higher median fasting C-peptide (0.21 nmol/l vs 0.10 nmol/l, p<0.001) compared with children without previous early-stage diagnosis. Fewer participants with prior early-stage diagnosis had ketonuria (22.2% vs 78.4%, p<0.001) or required insulin treatment (72.3% vs 98.1%, p<0.05) and only 2.5% presented with diabetic ketoacidosis at diagnosis of stage 3 type 1 diabetes. Outcomes in children with a prior early-stage diagnosis were not associated with a family history of type 1 diabetes or diagnosis during the COVID-19 pandemic. A milder clinical presentation was observed in children who participated in education and monitoring after early-stage diagnosis. Conclusions/interpretation: Diagnosis of presymptomatic type 1 diabetes in children followed by education and monitoring improved clinical presentation at the onset of stage 3 type 1 diabetes. Graphical Abstract: [Figure not available: see fulltext.].
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Children ; Early-stage Diagnosis ; Islet Autoantibodies ; Screening ; Type 1 Diabetes; Beta-cell Function; C-peptide; Ketoacidosis; Autoantibodies; Onset; Risk; Participation; Parents; Impact; Elisa
ISSN (print) / ISBN 0012-186X
e-ISSN 1432-0428
Journal Diabetologia
Quellenangaben Volume: 66, Issue: 9, Pages: 1633-1642 Article Number: , Supplement: ,
Publisher Springer
Publishing Place Berlin ; Heidelberg [u.a.]
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research Type 1 (IDF)
Institute for Pancreatic Beta Cell Research (IPI)
Grants Juvenile Diabetes Research Foundation