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Identification and Follow-up of At-Risk Children Mitigate Disease Severity and Improve Treatment Outcomes in Type 1
Oona Kähkönen1,2, Salla Kuusela2,3, Jutta E Laiho4
1Celiac Disease Research Center, Tampere University and Tampere University Hospital, Tampere, Finland.
Insights
Population screening for type 1 diabetes (T1D) identifies at-risk children who experience milder diagnoses. Early detection through programs like DIPP leads to better health outcomes and reduced T1D complications.
Area of Science:
- Endocrinology
- Pediatrics
- Genetics
Background:
- Population-based genetic screening for type 1 diabetes (T1D) is gaining interest.
- Limited data exists on treatment outcomes for individuals identified via screening.
Purpose of the Study:
- To compare clinical presentation and 1-year treatment outcomes in children with T1D identified through the DIPP screening program versus those diagnosed outside the program.
Main Methods:
- A cohort of 126 at-risk children from the DIPP study was compared with 440 children diagnosed with T1D outside the screening program.
- Characteristics at diagnosis and 1-year treatment outcomes were analyzed.
Main Results:
- DIPP participants showed significantly lower rates of ketoacidosis, dehydration, and intensive care needs.
- DIPP participants had lower HbA1c levels and insulin requirements at diagnosis and 1-year follow-up.
- Inpatient stays were shorter for DIPP participants.
Conclusions:
- Children identified through T1D screening (DIPP) present with milder clinical symptoms at diagnosis.
- Screening leads to improved glycemic control and reduced insulin needs in the first year post-diagnosis.
Objective:
Interest in screening for type 1 diabetes (T1D) is increasing, but studies assessing outcomes during the treatment period among individuals identified through population-based genetic screening and prospective follow-up remain limited.
Research Design And Methods:
Characteristics at T1D diagnosis and 1-year treatment outcomes were compared between 126 at-risk children followed in the Type 1 Diabetes Prediction and Prevention (DIPP) study and 440 children diagnosed outside the screening program.
Results:
DIPP participants had significantly less frequent (P < 0.05) ketoacidosis (5.6% vs. 23.6%), dehydration, electrolyte imbalances, and need for intensive care, and shorter inpatient stays, than non-DIPP children. They showed lower median HbA1c levels (46 vs. 99 mmol/mol [6.4 vs. 11.2%]) and insulin requirements (0.11 vs. 0.74 units/kg/day) both at diagnosis and 1 year later (55 vs. 61 mmol/mol [7.2 vs. 7.7%]; 0.57 vs. 0.70 units/kg/day).
Conclusions:
DIPP participants had a milder clinical presentation at T1D diagnosis, with lower HbA1c levels and lower insulin requirements during the first year.
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