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New definition for the partial remission period in children and adolescents with type 1 diabetes
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Mortensen, Henrik B. (author)
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Hougaard, Philip (author)
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Swift, Peter (author)
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Hansen, Lars (author)
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Holl, Reinhard W. (author)
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Hoey, Hilary (author)
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Bjoerndalen, Hilde (author)
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de Beaufort, Carine (author)
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Chiarelli, Francesco (author)
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Danne, Thomas (author)
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Schoenle, Eugen J. (author)
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- Åman, Jan (author)
- Örebro universitet,Hälsoakademin
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(creator_code:org_t)
- 2009-05-12
- 2009
- English.
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In: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 32:8, s. 1384-1390
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http://care.diabetes...
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https://urn.kb.se/re...
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https://doi.org/10.2...
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Abstract
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- OBJECTIVE To find a simple definition of partial remission in type 1 diabetes that reflects both residual beta-cell function and efficacy of insulin treatment. RESEARCH DESIGN AND METHODS A total of 275 patients aged <16 years were followed from onset of type 1 diabetes. After 1, 6, and 12 months, stimulated C-peptide during a challenge was used as a measure of residual beta-cell function. RESULTS By multiple regression analysis, a negative association between stimulated C-peptide and A1C (regression coefficient -0.21, P < 0.001) and insulin dose (-0.94, P < 0.001) was shown. These results suggested the definition of an insulin dose-adjusted A1C (IDAA1C) as A1C (percent) + [4 x insulin dose (units per kilogram per 24 h)]. A calculated IDAA1C < or =9 corresponding to a predicted stimulated C-peptide >300 pmol/l was used to define partial remission. The IDAA1C < or =9 had a significantly higher agreement (P < 0.001) with residual beta-cell function than use of a definition of A1C < or =7.5%. Between 6 and 12 months after diagnosis, for IDAA1C < or =9 only 1 patient entered partial remission and 61 patients ended partial remission, for A1C < or =7.5% 15 patients entered partial remission and 53 ended, for a definition of insulin dose < or =0.5 units . kg(-1) . 24 h(-1) 5 patients entered partial remission and 66 ended, and for stimulated C-peptide (>300 pmol/l) 9 patients entered partial remission and 49 ended. IDAA1C at 6 months has good predictive power for stimulated C-peptide concentrations after both 6 and 12 months. CONCLUSIONS A new definition of partial remission is proposed, including both glycemic control and insulin dose. It reflects residual beta-cell function and has better stability compared with the conventional definitions.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Keyword
- MEDICINE
- MEDICIN
- Diabetology
- Diabetologi
- Paediatric medicine
- Pediatrisk medicin
- Medicine
- Medicin
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Mortensen, Henri ...
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Hougaard, Philip
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Swift, Peter
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Hansen, Lars
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Holl, Reinhard W ...
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Hoey, Hilary
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show more...
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Bjoerndalen, Hil ...
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de Beaufort, Car ...
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Chiarelli, Franc ...
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Danne, Thomas
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Schoenle, Eugen ...
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Åman, Jan
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Endocrinology an ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
- Articles in the publication
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Diabetes Care
- By the university
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Örebro University