title: Shorter remission period in young versus older children with diabetes mellitus type 1.
abstract: BACKGROUND
  The initial period of diabetes type 1 is of great importance, since early metabolic adjustment has profound impact on long term control. The majority of pediatric centers in Germany participate in a national quality initiative, providing longitudinal data for central analysis.
  
  
  METHODS
  104543 anonymous data sets were obtained from 6123 pediatric patients under 18 years who were treated in 157 pediatric centers and monitored for 36 months at the same center starting from diagnosis.
  
  
  RESULTS
  Partial remission (insulin <0.5 U/kg/d and HbA1c < or = 7.0%) was present in 1992 children (32.5%) within the first 3 months after diagnosis. Remission phase lasted in average for 0.74 +/- 0.77 years and was significantly shorter in children below 10 years of age at onset of diabetes compared to the older patients. The remission period was significantly longer in boys, particularly in children under 10 years (p=0.0039). Multiple regression analysis showed a longer remission phase in children with pubertal diabetes onset. The children entering remission were younger, more often boys and had a lower initial HbA1c level.
  
  
  CONCLUSIONS
  These data from a large multicenter group of children with diabetes type 1 emphasize the influence of gender, pubertal stage and age at manifestation on the amount of insulin required, and therefore the clinical remission, during the first three years of the disease.
authors.affiliation: Department of Pediatrics, University of Jena, Jena, Germany. Axel.Dost@med.uni-jena.de
authors.forename: A
authors.initials: A
authors.lastname: Dost
authors.forename: A
authors.initials: A
authors.lastname: Herbst
authors.forename: K
authors.initials: K
authors.lastname: Kintzel
authors.forename: H
authors.initials: H
authors.lastname: Haberland
authors.forename: C L
authors.initials: CL
authors.lastname: Roth
authors.forename: L
authors.initials: L
authors.lastname: Gortner
authors.forename: R W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006442:Glycated Hemoglobin; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D011627:Puberty / Q000097:blood*; D012074:Remission Induction; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin; D006454:Hemoglobins; C517652:hemoglobin A1c protein, human