The remission phase in adolescents and young adults with newly diagnosed type 1 diabetes mellitus: prevalence, predicting factors and glycemic control during follow-up

Yazidi, Mériem; Mahjoubi, Sana; Oueslati, I.; Chaker, Fatma; Chihaoui, Mélika

doi:10.20945/2359-3997000000456

Cited by 3 publications

(3 citation statements)

References 31 publications

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“…Some authors have suggested presenting non-remission as an independent clinical entity with significantly poorer long-term outcomes than PR (31). Similar to our results, Yazidi et al have shown that the occurrence of remission defined by an HbA1c <6.5% with a daily insulin dose <0.5 IU/kg/day in adolescents and young adults with newly diagnosed T1D is associated with better glycemic control and lower insulin requirements during the first 5 years of follow-up (32). Niedzwiecki et al reported that the absence of remission was associated with the occurrence of chronic complications of diabetes at a seven year follow-up in young adults (33).…”

Section: Discussionsupporting

confidence: 91%

The Relationship Between Long-Term Glycemic Control and Partial Remission in Type 1 Diabetes: A Retrospective Study

2022

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Aim: Partial remission (PR) is a significant period in the early course of type 1 diabetes (T1D) with implications for diabetes management. We aimed to investigate whether long-term hemoglobin A1c (HbA1c) outcomes in T1D differed as a result of experiencing PR. We also analyzed the demographic and clinical factors that may influence long-term glycemic control. Material and methods: We retrospectively tracked the HbA1c values of 131 children and adolescents with T1D over a 5-year period. Patients were stratified into low (

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Section: Discussionsupporting

confidence: 91%

The Relationship Between Long-Term Glycemic Control and Partial Remission in Type 1 Diabetes: A Retrospective Study

2022

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“…Data from most subjects in the adult-onset group were collected within 12 months of disease onset, when the probability of remission phase is highest. Recently, it was shown that most patients in the age group 12–30 years experience their remission phase within one year after T1D onset and that the HbA1c level after one year was significantly lower in the remitters [ 37 ]. Overall, the hypothesis put forward by Wentzell et al [ 2 ] that an early age of T1D onset has a favourable effect on perceived diabetes distress later in life was confirmed.…”

Section: Discussionmentioning

confidence: 99%

Comparison of diabetes distress and depression screening results of emerging adults with type 1 diabetes onset at different ages: findings from the German early-onset T1D study and the German Diabetes Study (GDS)

Stahl‐Pehe

Bächle²,

Bódis³

et al. 2023

Diabetol Metab Syndr

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Background Diabetes distress is increasingly considered one of the most important psychosocial issues in the care of people with type 1 diabetes (T1D). We analyse whether diabetes distress and depression screening results of emerging adults are associated with the age at T1D onset. Methods Data were taken from two cohort studies conducted at the German Diabetes Center, Düsseldorf, Germany. The 18–30-year-old participants had an age at onset either before the age of 5 years (childhood-onset long-term T1D study group, N = 749) or during adulthood (adult-onset short-term T1D study group from the German Diabetes Study (GDS), N = 163). Diabetes distress and depression screening were analysed by means of the 20-item Problem Areas in Diabetes (PAID-20) scale and the nine-item depression module from the Patient Health Questionnaire (PHQ-9). The average causal effect of age at onset was estimated by a doubly robust causal inference method. Results The PAID-20 total scores were increased in the adult-onset study group [potential outcome mean (POM) 32.1 (95% confidence interval 28.0; 36.1) points] compared to the childhood-onset study group [POM 21.0 (19.6; 22.4) points, difference 11.1 (6.9; 15.3) points, p<0.001] adjusted for age, sex and haemoglobin A1c (HbA1c) levels. Moreover, more participants in the adult-onset group [POM 34.5 (24.9; 44.2) %] than in the childhood-onset group [POM 16.3 (13.3; 19.2) %] screened positive for diabetes distress [adjusted difference 18.3 (8.3; 28.2) %, p<0.001]. The PHQ-9 total score [difference 0.3 (-1.1; 1.7) points, p=0.660] and the proportion of participants with a positive screening result for depression [difference 0.0 (-12.7; 12.8) %, p=0.994] did not differ between the groups in the adjusted analyses. Conclusions Emerging adults with short-term type 1 diabetes screened positive for diabetes distress more often than adults with type 1 diabetes onset during early childhood when age, sex and HbA1c values were considered confounding factors. Accounting for age at onset or the duration of diabetes may help explain the heterogeneity in the data when psychological factors are examined.

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“…The overall duration of the remission phase ranges widely between 1 month and 13 years [ 15 ], with an average of 7 months [ 16 ]. It has been shown that the occurrence of remission in T1D is associated with remarkable clinical advantages in the long-term, as remitters exhibit better glycemic control and lower insulin requirements during the first 5 years of follow-up [ 17 ], along with a reduced risk of chronic microvascular complications of diabetes compared to non-remitters [ 18 ]. This is probably due to the higher retention of endogenous insulin and C-peptide secretion in T1D patients who experience clinical remission [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

BNT162b2 mRNA COVID-19 Vaccine Does Not Impact the Honeymoon Phase in Type 1 Diabetes: A Case Report

Infante

Fabbri

Padilla³

et al. 2022

Vaccines

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Type 1 diabetes (T1D), which is caused by the autoimmune destruction of insulin-secreting pancreatic beta cells, represents a high-risk category requiring COVID-19 vaccine prioritization. Although COVID-19 vaccination can lead to transient hyperglycemia (vaccination-induced hyperglycemia; ViHG), its influence on the course of the clinical remission phase of T1D (a.k.a. “honeymoon phase”) is currently unknown. Recently, there has been an increasing concern that COVID-19 vaccination may trigger autoimmune phenomena. We describe the case of a 24-year-old young Italian man with T1D who received two doses of the BNT162b2 mRNA (Pfizer-BioNTech) COVID-19 vaccine during a prolonged honeymoon phase. He experienced a transient impairment in glucose control (as evidenced by continuous glucose monitoring) that was not associated with substantial changes in stimulated C-peptide levels and islet autoantibody titers. Nonetheless, large prospective studies are needed to confirm the safety and the immunometabolic impact of the BNT162b2 vaccine in T1D patients during the honeymoon phase. Thus far, T1D patients who are going to receive COVID-19 vaccination should be warned about the possible occurrence of transient ViHG and should undergo strict postvaccination surveillance.

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The remission phase in adolescents and young adults with newly diagnosed type 1 diabetes mellitus: prevalence, predicting factors and glycemic control during follow-up

Cited by 3 publications

References 31 publications

The Relationship Between Long-Term Glycemic Control and Partial Remission in Type 1 Diabetes: A Retrospective Study

The Relationship Between Long-Term Glycemic Control and Partial Remission in Type 1 Diabetes: A Retrospective Study

Comparison of diabetes distress and depression screening results of emerging adults with type 1 diabetes onset at different ages: findings from the German early-onset T1D study and the German Diabetes Study (GDS)

BNT162b2 mRNA COVID-19 Vaccine Does Not Impact the Honeymoon Phase in Type 1 Diabetes: A Case Report

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