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

Marie Louise Max Andersen, Lotte B Nielsen, Jannet Svensson, Sven Pörksen, Philip Hougaard, Craig Beam, Carla Greenbaum, Dorothy Becker, Jacob S Petersen, Lars Hansen, Henrik B Mortensen

12 Citationer (Scopus)

Abstract

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.

OriginalsprogEngelsk
TidsskriftPediatric Diabetes
Vol/bind15
Udgave nummer5
Sider (fra-til)345-354
Antal sider10
ISSN1399-543X
DOI
StatusUdgivet - aug. 2014

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