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Beta cell function ...
Beta cell function after intensive subcutaneous insulin therapy or intravenous insulin infusion at onset of type 1 diabetes in children without ketoacidosis.
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- Enander, Rebecka (author)
- SkaS Hosp Grp, Sweden
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- Adolfsson, Peter, 1963 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Hosp Halland, Sweden; Univ Gothenburg, Sweden
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- Bergdahl, Torun (author)
- SkaS Hosp Grp, Sweden
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- Forsander, Gun, 1951 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden
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- Ludvigsson, Johnny (author)
- Linköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten,Region Östergötland, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus
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- Hanås, Ragnar, 1951 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Univ Gothenburg, Sweden; NU Hosp Grp, Sweden
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(creator_code:org_t)
- 2018-04-15
- 2018
- English.
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In: Pediatric diabetes. - : Hindawi Limited. - 1399-5448 .- 1399-543X. ; 19:6, s. 1079-1085
- Related links:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Subject headings
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- Our aim was to see if IV insulin therapy at diagnosis preserves beta-cell function better than multiple subcutaneous (SC) injections.Fifty-four children 9.9 ± 3.5years (range 2.8-14.9) without ketoacidosis were included in a 2years, randomized multicenter study with insulin SC or 48 to 72hours IV initially. Thirty-three (61%) were boys, 22 (41%) were pubertal. Forty-eight subjects completed 12 months follow-up and 43 completed 24 months. At 1, 6, 12, and 24 months, hemoglobin A1c (HbA1c), C-peptide and insulin/kg/24 h were measured. At 24 months, a mixed-meal tolerance test (MMTT) was performed.HbA1c at diagnosis was 10.7%, (93mmol/mol) for IV, 10.7%, (94mmol/mol) for SC. During the first 2 full days of insulin therapy, mean plasma glucose was 8.2 mmol/L for IV, 9.5 for SC (P =.025). Mean insulin dose was 1.5 U/kg/d for IV vs 1.0 for SC (P =.001). Sixteen (7 in IV, 9 in SC group) started with insulin pumps during the follow-up. At 24 months, we saw no significant differences: HbA1c (7.5%, 58mmol/mol, for IV, 7.2%, 55mmol/mol, for SC; ns), insulin doses (0.79 vs 0.88U/kg/d; ns), fasting C-peptide (0.08 vs 0.12nmol/L; ns), maximal MMTT response (0.19 vs 0.25nmol/L; ns) and AUC (18.26 vs 23.9 nmol/L*min; ns). Peak C-peptide >0.2 nmol/L in the combined IV and SC groups correlated significantly with HbA1c and C-peptide at onset in a multiple regression.Residual beta cell function at 2years seems to be independent from initial insulin regimens but related to HbA1c and C-peptide at onset.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Keyword
- children
- C‐peptide
- HbA1c
- type 1 diabetes
- children; C-peptide; HbA1c; type 1 diabetes
Publication and Content Type
- ref (subject category)
- art (subject category)
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