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Partial remission phase of diabetes in children younger than age 10 years
B J Muhammad1, P G Swift, N T Raymond
1The Children's Hospital, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
Insights
Type 1 diabetes remission is possible in young children, even those under 5. Early interventions may help preserve pancreatic beta cell function, reducing insulin needs.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Diabetes Research
Background:
- Renewed interest exists in the partial remission phase of recently diagnosed diabetes.
- Preserving beta cell function is a key goal for pharmacological and immune interventions.
- Understanding factors influencing remission in children is crucial for early treatment strategies.
Purpose of the Study:
- To investigate the influence of age, sex, diabetic ketoacidosis (DKA), hospital admission, and ethnicity on remission rates and insulin requirements in children with diabetes.
- To assess the potential for preserving beta cell function in young children with diabetes.
Main Methods:
- A study involving 95 children younger than 10 years with recently diagnosed diabetes.
- Partial remission defined as insulin requirement < 0.5 U/kg body weight/day.
- Analysis of remission rates and insulin needs based on age, sex, DKA status, admission, and ethnicity over two years.
Main Results:
- Partial remission was observed in 41 out of 95 patients.
- No significant differences in remission rates were found based on age groups (2-4 vs. 5-9 years), DKA, hospital admission, sex, or South Asian ethnicity.
- None of the five children younger than 2 years achieved remission.
- Insulin requirements showed no significant differences between groups by the end of two years.
Conclusions:
- Partial remission is achievable in children with diabetes, including those in preschool age.
- The study suggests potential for interventions aimed at preserving beta cell function even in very young children.
- Factors like DKA, hospital admission, sex, and ethnicity did not significantly impact remission rates in this cohort.
Abstract:
There is renewed interest in the phase of partial remission in recently diagnosed diabetes because of the potential for pharmacological and immune intervention to preserve beta cell function. 95 children younger than 10 years were investigated to assess the influence of age, sex, diabetic ketoacidosis (DKA), admission at diagnosis, and ethnicity on the frequency of remission and insulin requirements during the first two years after diagnosis. Partial remission was defined as a requirement of insulin < 0.5 U/kg body weight/day. There was partial remission in 41 patients, with no differences for children aged 2-4 years and those aged 5-9 years. None of the five children aged < 2 years remitted. Forty five of 95 children were admitted to hospital at diagnosis, of whom 26 of 45 had DKA (blood pH < 7.25). In this number of children we were unable to show a statistical difference in the rate of remission with respect to DKA, admission to hospital at diagnosis, sex, or South Asian ethnic background. There were no differences in insulin requirements between the different groups by the end of two years and at that time seven of the children required insulin < 0.5 U/kg/day. The results suggest that even in preschool children there is potential for attempting to preserve beta cell function.