Disease progression among 446 children with newly diagnosed type 1 diabetes located in Scandinavia, Europe, and North America during the last 27 yr

TY - JOUR

T1 - Disease progression among 446 children with newly diagnosed type 1 diabetes located in Scandinavia, Europe, and North America during the last 27 yr

AU - Andersen, Marie Louise Max

AU - Nielsen, Lotte B

AU - Svensson, Jannet

AU - Pörksen, Sven

AU - Hougaard, Philip

AU - Beam, Craig

AU - Greenbaum, Carla

AU - Becker, Dorothy

AU - Petersen, Jacob S

AU - Hansen, Lars

AU - Mortensen, Henrik B

N1 - © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2014/8

Y1 - 2014/8

N2 - Objective: To clarify whether the rate of decline in stimulated C-peptide (SCP) from 2 to 15months after diagnosis has changed over an interval of 27yr. Research design and methods: The rate of decline in SCP levels at 1, 2, 3, 6, 9, 12, and 15months after diagnosis was compared in four paediatric cohorts from Scandinavian and European countries including 446 children with new onset type 1 diabetes (T1D, 1982-2004). Findings were evaluated against 78 children (2004-2009) from the TrialNet studies. Results: The mean rate of decline [%/month (±SEM)] in SCP for a 10-yr-old child was 7.7%/month (±1.5) in the 1982-1985 Cohort, 6.3%/month (±1.7) in the 1995-1998 Cohort, 7.8%/month (±0.7) in the 1999-2000 Cohort, and 10.7%/month (±0.9) in the latest 2004-2005 Cohort (p=0.05). Including the TrialNet Cohort with a rate of decline in SCP of 10.0%/month (±0.9) the differences between the cohorts are still significant (p=0.039). The rate of decline in SCP was negatively associated with age (p<0.0001), insulin antibodies (IA) (p=0.003), and glutamic acid decarboxylase-65 (GAD65A) (p=0.03) initially with no statistically significant effect of body mass index (BMI) Z-score at 3months. Also, at 3months the time around partial remission, the effect of age on SCP was significantly greater in children ≤5yr compared with older children (p≤0.0001). Conclusions: During the past 27yr, initial C-peptide as well as the rate of C-peptide decline seem to have increased. The rate of decline was affected significantly by age, GAD65A, and IA, but not BMI Z-score or initial C-peptide.

AB - Objective: To clarify whether the rate of decline in stimulated C-peptide (SCP) from 2 to 15months after diagnosis has changed over an interval of 27yr. Research design and methods: The rate of decline in SCP levels at 1, 2, 3, 6, 9, 12, and 15months after diagnosis was compared in four paediatric cohorts from Scandinavian and European countries including 446 children with new onset type 1 diabetes (T1D, 1982-2004). Findings were evaluated against 78 children (2004-2009) from the TrialNet studies. Results: The mean rate of decline [%/month (±SEM)] in SCP for a 10-yr-old child was 7.7%/month (±1.5) in the 1982-1985 Cohort, 6.3%/month (±1.7) in the 1995-1998 Cohort, 7.8%/month (±0.7) in the 1999-2000 Cohort, and 10.7%/month (±0.9) in the latest 2004-2005 Cohort (p=0.05). Including the TrialNet Cohort with a rate of decline in SCP of 10.0%/month (±0.9) the differences between the cohorts are still significant (p=0.039). The rate of decline in SCP was negatively associated with age (p<0.0001), insulin antibodies (IA) (p=0.003), and glutamic acid decarboxylase-65 (GAD65A) (p=0.03) initially with no statistically significant effect of body mass index (BMI) Z-score at 3months. Also, at 3months the time around partial remission, the effect of age on SCP was significantly greater in children ≤5yr compared with older children (p≤0.0001). Conclusions: During the past 27yr, initial C-peptide as well as the rate of C-peptide decline seem to have increased. The rate of decline was affected significantly by age, GAD65A, and IA, but not BMI Z-score or initial C-peptide.

KW - Body Mass Index

KW - C-Peptide

KW - Child

KW - Child, Preschool

KW - Cohort Studies

KW - Diabetes Mellitus, Type 1

KW - Disease Progression

KW - Europe

KW - European Continental Ancestry Group

KW - Female

KW - Glutamate Decarboxylase

KW - Humans

KW - Infant

KW - Insulin Antibodies

KW - Male

KW - North America

KW - Scandinavian and Nordic Countries

U2 - 10.1111/pedi.12098

DO - 10.1111/pedi.12098

M3 - Journal article

C2 - 24731251

SN - 1399-543X

VL - 15

SP - 345

EP - 354

JO - Pediatric Diabetes

JF - Pediatric Diabetes

IS - 5

ER -