Clinical Outcomes in Pediatric Patients With Type 1 Diabetes With Early Versus Late Diagnosis: Analysis From the DPV Registry

Hammersen J, Tittel SR, Kamrath C, Warncke K, Galler A, Menzel U, Hess M, Meißner T, Karges B, Holl RW (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Diabetes Care American Diabetes Association

Book Volume: 47

Pages Range: 1808-1817

Journal Issue: 10

DOI: 10.2337/dc24-0625

Abstract

OBJECTIVE This study was conducted to evaluate the effects of early clinical diagnosis of type 1 diabetes by comparison of clinical parameters at diagnosis and during follow-up in patients with pediatric type 1 diabetes with early, intermediate, and late diagnosis. RESEARCH DESIGN AND METHODS In a population-based analysis, data on 14,292 pediatric patients with type 1 diabetes diagnosed between 2015 and 2019 were retrieved from the Diabetes Prospective Documentation (DPV) registry in March 2023. Patients were divided into four groups: one with diabetic ketoacidosis (DKA) at diagnosis and three with early, intermediate, or late diagnosis based on age-dependent HbA1c terciles. Laboratory-measured HbA1c values and those estimated from continuous glucose monitoring were aggregated as a combined glucose indicator (CGI). Insulin dose– adjusted CGI values <9% were defined as partial remission. RESULTS At diagnosis, patients had a median age of 9.8 years (IQR 6.8; 13.0). Three years later, patients with early diagnosis had lower CGI than patients with late diagnosis or DKA (mean [95% CI] 7.46% [7.40; 7.53] vs. 7.81% [7.75; 7.87] or 7.74% [7.68; 7.79], respectively; each P < 0.001). More patients experienced partial remission (12.6% [11.0; 14.4] vs. 9.1% [7.7; 10.7] or 8.6% [7.3; 10.0]; each P < 0.001), and 11.7% [10.2; 13.5] of patients with intermediate diagnosis were in partial remission. CONCLUSIONS Early clinical diagnosis of type 1 diabetes may be beneficial for metabolic control and remission after 3 years of follow-up. Patients diagnosed early may represent a distinct group with better resources or with a different disease biology and slower b-cell destruction, which needs further evaluation.

Involved external institutions

Albert-Ludwigs-Universität Freiburg DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Universität Ulm DE Germany (DE) Technische Universität München (TUM) DE Germany (DE) Universitäts-Kinderspital beider Basel (UKBB) CH Switzerland (CH) Altonaer Kinderkrankenhaus (AKK) DE Germany (DE) Universitätsklinikum Düsseldorf DE Germany (DE) Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen DE Germany (DE)

How to cite

APA:

Hammersen, J., Tittel, S.R., Kamrath, C., Warncke, K., Galler, A., Menzel, U.,... Holl, R.W. (2024). Clinical Outcomes in Pediatric Patients With Type 1 Diabetes With Early Versus Late Diagnosis: Analysis From the DPV Registry. Diabetes Care, 47(10), 1808-1817. https://doi.org/10.2337/dc24-0625

MLA:

Hammersen, Johanna, et al. "Clinical Outcomes in Pediatric Patients With Type 1 Diabetes With Early Versus Late Diagnosis: Analysis From the DPV Registry." Diabetes Care 47.10 (2024): 1808-1817.

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