Partial remission in type 1 diabetes and associated factors: Analysis based on the insulin dose-adjusted hemoglobin A1c in children and adolescents from a regional diabetes center, Auckland, New Zealand

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Chiavaroli, ValentinaUniv Auckland, Liggins Inst, Auckland, New Zealand;Pescara Publ Hosp, Neonatal Intens Care Unit, Pescara, Italy (author)

Partial remission in type 1 diabetes and associated factors : Analysis based on the insulin dose-adjusted hemoglobin A1c in children and adolescents from a regional diabetes center, Auckland, New Zealand

Article/chapterEnglish2019

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2019-07-04
John Wiley & Sons,2019
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LIBRIS-ID:oai:DiVA.org:uu-398708
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-398708URI
https://doi.org/10.1111/pedi.12881DOI

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Language:English
Summary in:English

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Background Partial remission (PREM) by the insulin dose-adjusted HbA1c (IDAA1c) method has not been evaluated for the combined associations of ethnicity and socioeconomic status in children and adolescents with type 1 diabetes (T1D). Objective To investigate prevalence and predictors of PREM defined by IDAA1c. Methods Six hundred fourteen of 678 children (aged <15 years) with new-onset T1D (2000-2013) from a regional pediatric diabetes service (Auckland, New Zealand). Results Overall rate of PREM at 3 months was 42.4%, and lower in Maori/Pacific children (28.6%; P = .006) and those of other ethnicities (28.8%; P = .030) compared with New Zealand Europeans (50.4%). Comparing the most and least deprived socioeconomic quintiles, the odds of PREM were lower among the most deprived (adjusted odds ratio [aOR] 0.44; P = .019). Lower rates of PREM were seen in children aged 0 to 4.9 years (23.8%) and 10 to 14 years (40.9%) than in children aged 5 to 9.9 years (57.4%; P < .05). Further predictors of lower rates of PREM were ketoacidosis at diagnosis (aOR 0.54 with DKA; P = .002) and diabetes duration (aOR 0.84 per month; P < .0001). Patient's sex, body mass index standard deviation score, or autoantibodies were not associated with PREM. PREM at 3 months was associated with lower HbA1c over 18 months compared with children not in PREM (65.0 vs 71.3 mmol/mol; P < .0001), independent of ketoacidosis. Conclusions This study on a regional cohort of youth with T1D showed social and ethnic disparities in rates of PREM defined by IDAA1c. Further research into reducing ketoacidosis rates at diagnosis and addressing factors associated with lower rates of PREM in non-European children are important health priorities.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Pediatrik hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Pediatrics hsv//eng
adolescents
children
ethnicity
ketoacidosis
partial remission
socioeconomic status
type 1 diabetes

Added entries (persons, corporate bodies, meetings, titles ...)

Derraik, Jose G. B.Uppsala universitet,Institutionen för kvinnors och barns hälsa,Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand (author)
Jalaludin, Muhammad Y.Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Malaya, Fac Med, Kuala Lumpur, Malaysia (author)
Albert, Benjamin B.Univ Auckland, Liggins Inst, Auckland, New Zealand;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand (author)
Ramkumar, SelvarajanApollo Hosp, Dept Endocrinol, Chennai, Tamil Nadu, India;Madras Med Coll & Govt Gen Hosp, Dept Endocrinol, Chennai, Tamil Nadu, India (author)
Cutfield, Wayne S.Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand (author)
Hofman, Paul L.Univ Auckland, Liggins Inst, Auckland, New Zealand;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand (author)
Jefferies, Craig A.Univ Auckland, Liggins Inst, Auckland, New Zealand;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand (author)
Univ Auckland, Liggins Inst, Auckland, New Zealand;Pescara Publ Hosp, Neonatal Intens Care Unit, Pescara, ItalyInstitutionen för kvinnors och barns hälsa (creator_code:org_t)

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In:Pediatric Diabetes: John Wiley & Sons20:7, s. 892-9001399-543X1399-5448

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