title: Redefining the clinical remission period in children with type 1 diabetes.
abstract: OBJECTIVE
  To redefine the clinical remission period for different aged children receiving the current standard of diabetes care.
  
  
  METHODS
  An electronic patient records system was used to identify 552 children newly diagnosed with type 1 diabetes (T1D) from 1997 to 2001 who had an initial hemoglobin A1c (HbA1c) value at the time of diagnosis and at least one other value measured in the ensuing year. The insulin dosage previously used to define the remission period [<0.5 units per kg body weight per day (U/kg/d)] was evaluated for the different aged children.
  
  
  RESULTS
  The mean insulin dosages for all age groups were >0.5 U/kg/d by 9 months after diagnosis. The mean HbA1c values were above 8% by 6 months after diagnosis for the 6-9 and the 10-12 yr age groups and by 9 months after diagnosis for the >or=13 yr age group. The percentage of children <or=5 yr of age who continued to receive <0.5 U/kg/d of insulin was higher than for the other three age groups. However, this group did not achieve a mean HbA1c value <8% at any time.
  
  
  CONCLUSIONS
  Older children have a longer remission period than younger children. The clinical definition of the remission period should be redefined to include both the insulin dose and the HbA1c level. Any attempt to extend the remission period in children is more apt to be successful in dealing with older children and with the introduction of the intervention as soon after diagnosis as is feasible.
authors.affiliation: University of Colorado Health Sciences Center, Denver, CO 80262, USA. peter.chase@uchsc.edu
authors.forename: H Peter
authors.initials: HP
authors.lastname: Chase
authors.forename: Todd A
authors.initials: TA
authors.lastname: MacKenzie
authors.forename: Jonathan
authors.initials: J
authors.lastname: Burdick
authors.forename: Rosanna
authors.initials: R
authors.lastname: Fiallo-Scharer
authors.forename: Philippe
authors.initials: P
authors.lastname: Walravens
authors.forename: Georgeanna
authors.initials: G
authors.lastname: Klingensmith
authors.forename: Marian
authors.initials: M
authors.lastname: Rewers
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology*; D004305:Dose-Response Relationship, Drug; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008499:Medical Records; D012074:Remission Induction; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin