ISPAD Clinical Practice Consensus Guidelines 2018: Stages of type 1 diabetes in children and adolescents

Remission phase in children diagnosed with type 1 diabetes in years 2012 to 2013 in Silesia, Poland: An observational study

“…Based on these two values the presence and duration of PR were determined. PR was defined as a period with insulin requirements of less than 0.5 U/kg/day accompanied by hemoglobin A1c (HbA1c) level of less or equal to 7%; 53 mmol/mol (ISPAD Consensus Guidelines 2018) …”

Outcomes of algorithm-based modifications of insulinotherapy during exercise in MDI vs insulin pump-treated children with type 1 diabetes: Results from the TREAD-DIAB study

“…Inclusion criteria were as follows: age at trial onset between 7 and 18 years, diagnosis of T1D according to the ISPAD 2014 guidelines, treatment with insulin pump therapy or basal‐prandial insulin regimen with multiple daily injections (MDI), T1D outside of partial remission phase (defined according to the insulin dose‐adjusted A1C [IDAA1C] definition, being equal to HbA1c (%) + [4 × insulin dose (units/kg/24 h)] and at least >2 years after T1D diagnosis (defined as the first day of insulin therapy) and/or diagnosis of T1D for more than 2 years (based on the first day of insulinotherapy), HbA1c level ≤9.5% during the last control visit. Criteria for exclusion were: patients with non‐T1D, patients not treated with insulin pump therapy or basal‐prandial insulin regimen, history of recurrent severe hypoglycemia, presence of specific co‐morbidities as severe neonatal asphyxia (defined as Apgar score ≤3 after 5 minutes), children born small for gestational age, chronic systemic disease, active malignancy, hypothyroidism, hypopituitarism, developmental delay, bladder dysfunction, obesity (ie, body mass index [BMI] >95th percentile according to Belgian reference charts) intake of drugs interfering with insulin sensitivity (eg, corticosteroids or human recombinant growth hormone), carnitine deficiency, β‐oxidation defect, cardiac malformation, dysrhythmia, or any medical condition not suitable for completing the exercise protocol on a treadmill.…”

“…Inclusion criteria were as follows: age at trial onset between 7 and 18 years, diagnosis of T1D according to the ISPAD 2014 guidelines, 19…”

ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents

“…Youth progress through three stages at variable rates: stage 1 is characterized by the presence of β‐cell autoimmunity with normoglycemia and a lack of clinical symptoms, which can last for months to many years, stage 2 is progresses to dysglycemia but remains asymptomatic, and stage 3 is defined as the onset of symptomatic disease . The phases of diabetes are discussed in chapter 3 (add ref) …”