Menu

Javascript is not activated in your browser. This website needs javascript activated to work properly.
You are here

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

Author:
  • Markus Lundgren
  • Åsa Sahlin
  • Camilla Svensson
  • Annelie Carlsson
  • Elisabeth Cedervall
  • Björn Jönsson
  • Ida Jönsson
  • Karin Larsson
  • Åke Lernmark
  • Jan Neiderud
  • Tore Vigård
  • Helena Larsson
Publishing year: 2014
Language: English
Pages: 494-501
Publication/Series: Pediatric Diabetes
Volume: 15
Issue: 7
Document type: Journal article
Publisher: Wiley-Blackwell

Abstract english

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.

Keywords

  • Endocrinology and Diabetes
  • Pediatrics
  • diabetic ketoacidosis
  • follow-up studies
  • HbA1c
  • type 1 diabetes

Other

Published
  • Diabetes and Celiac Unit
  • ISSN: 1399-543X
E-mail: ake [dot] lernmark [at] med [dot] lu [dot] se

Principal investigator

Diabetes and Celiac Unit

+46 40 39 19 01

+46 70 616 47 79

60:11:015

Jan Waldenströms gata 35, Malmö

33

Lund University Diabetes Centre, CRC, SUS Malmö, Jan Waldenströms gata 35, House 91:12. SE-214 28 Malmö. Telephone: +46 40 39 10 00