New Definition for the Partial Remission Period in Children and Adolescents With Type 1 Diabetes  

Oleh:

Mortensen, Henrik B. ; Hougaard, Philip ; Swift, Peter ; Hansen, Lars

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 32 no. 08 (Aug. 2009), page 1384-1390 .

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K.2009.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

OBJECTIVE To find a simple definition of partial remission in type 1 diabetes that reflects both residual ß-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 ß-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 × insulin dose (units per kilogram per 24 h)]. A calculated IDAA1C =9 corresponding to a predicted stimulated C-peptide >300 pmol/l was used to define partial remission. The IDAA1C =9 had a significantly higher agreement (P < 0.001) with residual ß-cell function than use of a definition of A1C =7.5%. Between 6 and 12 months after diagnosis, for IDAA1C =9 only 1 patient entered partial remission and 61 patients ended partial remission, for A1C =7.5% 15 patients entered partial remission and 53 ended, for a definition of insulin dose =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 ß-cell function and has better stability compared with the conventional definitions.

Opini Anda

Klik untuk menuliskan opini Anda tentang koleksi ini!

Kembali