Children diagnosed with presymptomatic type 1 diabetes through public health screening have milder diabetes at clinical manifestation
Publikation: Beitrag in Fachzeitschrift › Forschungsartikel › Beigetragen › Begutachtung
Beitragende
- Technische Universität München
- Nuremberg Hospital South
- Klinikum Bayreuth GmbH
- Universitätsklinikum Augsburg
- AMEOS Klinikum St. Elisabeth Neuburg
- Klinikum Dritter Orden gGmbH
- Hospital Kempten
- Medizinische Versorgungszentrum (MVZ) Leopoldina GmbH
- RoMed Hospital
- Hospital Traunstein
- Hospital Weiden
- KJF Klinikum Josefinum
- Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt
Abstract
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.].
Details
Originalsprache | Englisch |
---|---|
Seiten (von - bis) | 1633-1642 |
Seitenumfang | 10 |
Fachzeitschrift | Diabetologia |
Jahrgang | 66 |
Ausgabenummer | 9 |
Publikationsstatus | Veröffentlicht - Sept. 2023 |
Peer-Review-Status | Ja |
Externe IDs
PubMed | 37329450 |
---|---|
ORCID | /0000-0002-8704-4713/work/150880749 |
ORCID | /0000-0001-5272-9811/work/150884784 |
Schlagworte
Ziele für nachhaltige Entwicklung
ASJC Scopus Sachgebiete
Schlagwörter
- Children, Early-stage diagnosis, Islet autoantibodies, Screening, Type 1 diabetes