Effect of screening for type 1 diabetes on early metabolic control: the DiPiS study

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@article{b03fb003fc6e4de8a23832ad201149ba,
title = "Effect of screening for type 1 diabetes on early metabolic control: the DiPiS study",
abstract = "Aims/hypothesis: It has been shown that children previously enrolled in follow-up studies have better glycaemic control during the early period after diabetes diagnosis. The aim of this study was to analyse glycaemic control over a longer period, past the period of partial remission, after diagnosis in children followed before diagnosis in the Swedish Diabetes Prediction in Sk{\aa}ne (DiPiS) study compared with children of equal age not enrolled in pre-diabetes follow-up, receiving equivalent diabetes care. Methods: HbA1c from diagnosis and for the following 5 years, as well as differences in insulin dosage, BMI, pump use, partial remission according to insulin dose-adjusted HbA1c and baseline demographics were compared between children who were enrolled in follow-up and had received information on diabetes risk (n = 51) and children not enrolled in follow-up (n = 78). Results: The group followed before diagnosis had a higher proportion of first-degree relatives (FDRs) with diabetes (28{\%} vs 5.6{\%}; p = 0.001) and a higher proportion of participants with mothers born in Sweden (100{\%} vs 89{\%}; p = 0.02). No significant differences in total daily insulin dose, pump use or other baseline sociodemographic factors were detected between the groups. Median HbA1c at diagnosis and at 1, 2, 3, 4 and 5 years after diabetes diagnosis was significantly lower in children followed before diagnosis (all p < 0.05), and was not related to FDR status. Conclusions/interpretation: Compared with controls not previously enrolled in follow-up, our study shows that children enrolled in longitudinal follow-up before the diagnosis of diabetes have better glycaemic control, measured by HbA1c, up to 5 years after diagnosis and during the initial period of partial remission. Improved glycaemic control in the initial years of living with type 1 diabetes could affect long-term outcome and complications and might also improve study enrolment in future longitudinal studies.",
keywords = "Longitudinal studies, Metabolic control, Screening, Type 1 diabetes",
author = "{DiPiS Study Group} and Markus Lundgren and Berglind Jonsdottir and {Elding Larsson}, Helena",
year = "2019",
doi = "10.1007/s00125-018-4706-z",
language = "English",
volume = "62",
pages = "53--57",
journal = "Diabetologia",
issn = "1432-0428",
publisher = "Springer",
number = "1",

}