Follow-Up Before Diagnosis Improved Metabolic Control in Children With Type I Diabetes

Investigators sought to determine whether participants who were followed-up before their diagnosis of diabetes had improved metabolic control afterward.

Children at increased risk for type 1 diabetes and who were enrolled in longitudinal follow-up before being diagnosed with diabetes have better metabolic control when they are diagnosed, and the positive effect on HbA1c lasts for at least 5 years, according to a study published in Diabetologia.

The Diabetes Prediction in Skåne (DiPiS) study is a prospective, longitudinal study conducted in Sweden of children who are at increased risk for type 1 diabetes. The goal of the current study was to assess glycemic control during a longer period, past the period of partial remission and after diagnosis, in children who participated in the DiPiS. Participants in the DiPiS were then compared with children who were not enrolled and who are receiving equivalent diabetes care.

The cohort included 129 children diagnosed with diabetes: 51 in the group that was followed (FU) and 78 who did not participate in the DiPiS (NFU). The mean age at diagnosis was 6.8±2.9 standard deviation years in the FU group and 6.5±2.6 standard deviation years in the NFU group.

There was no significant difference in total daily insulin use between the 2 groups (all P >.05), and the use of insulin pumps during follow-up and the proportion of children using them did not differ between the 2 groups at any point. HbA1c levels at diagnosis were significantly lower in the FU group vs NFU (P =.006), as well as at 1 year (P =.012), 2 years (P =.002), 3 years (P =.014), 4 years (P =.001), and 5 years (P =.012) after diagnosis. The median HbA1c during the full 5-year follow-up was also lower for the FU group (53.3 mmol/mol) vs NFU patients (57.7 mmol/mol; P =.001).

“This improved glycemic control could improve long-term outcome and reduce the risk [for] complications,” concluded the authors.

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Lundgren M, Jonsdottir B, Elding Larsson H; DiPiS study group. Effect of screening for type 1 diabetes on early metabolic control: the DiPiS study [published online August 14, 2018]. Diabetologia. doi: 10.1007/s00125-018-4706-z