Children diagnosed with presymptomatic type 1 diabetes through public health screening have milder diabetes at clinical manifestation
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
- Technical University of Munich
- Nuremberg Hospital South
- Klinikum Bayreuth GmbH
- University Hospital Augsburg
- St Elisabeth Klinik
- Hospital Dritter Orden gGmbH
- Hospital Kempten
- Medical Care Center (MVZ) Leopoldina GmbH
- RoMed Hospital
- Hospital Traunstein
- Hospital Weiden
- KJF Klinikum Josefinum
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
Original language | English |
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Pages (from-to) | 1633-1642 |
Number of pages | 10 |
Journal | Diabetologia |
Volume | 66 |
Issue number | 9 |
Publication status | Published - Sept 2023 |
Peer-reviewed | Yes |
External IDs
PubMed | 37329450 |
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ORCID | /0000-0002-8704-4713/work/150880749 |
ORCID | /0000-0001-5272-9811/work/150884784 |
Keywords
Sustainable Development Goals
ASJC Scopus subject areas
Keywords
- Children, Early-stage diagnosis, Islet autoantibodies, Screening, Type 1 diabetes