Pediatric diabetes consortium T1D New Onset (NeOn) study: clinical outcomes during the first year following diagnosis.
OBJECTIVE
There have been few prospective, multicenter studies investigating the natural history of type 1 diabetes (T1D) from the time of diagnosis. The objective of this report from the Pediatric Diabetes Consortium (PDC) T1D New Onset (NeOn) study was to assess the natural history and clinical outcomes in children during the first year after diagnosis of T1D.


METHODS
Clinical measures from the first year following diagnosis were analyzed for 857 participants (mean age 9.1 yr, 51% female, 66% non-Hispanic White) not participating in an intervention study who had a HbA1c result at 12 months.


RESULTS
Mean HbA1c ± SD was 102 ± 25 mmol/mol (11.4 ± 2.3%) at diagnosis, 55 ± 12 mmol/mol (7.2 ± 1.1%) at 3 months, 56 ± 15 mmol/mol (7.3 ± 1.3%) at 6 months and 62 ± 16 mmol/mol (7.8 ± 1.5%) at 12 months from diagnosis. A severe hypoglycemic (SH) event occurred in 31 (4%) participants (44 events, 5.2 events per 100 person-years). Diabetic ketoacidosis (DKA) not including diagnosis occurred in 10 (1%) participants (13 events, 1.5 events per 100 person-years).


CONCLUSIONS
After onset of T1D, mean HbA1c reaches its nadir at 3-6 months with a gradual increase through 12 months. SH and DKA are uncommon but still occur during the first year with T1D. Data from large cohorts, such as the PDC T1D NeOn study, provide important insights into the course of T1D during the first year following diagnosis, which will help to inform the development of models to target future interventions.
Department of Pediatric Endocrinology, Yale University, New Haven, CT, 06520, USA.
Eda
E
Cengiz
Crystal G
CG
Connor
Katrina J
KJ
Ruedy
Roy W
RW
Beck
Craig
C
Kollman
Georgeanna J
GJ
Klingensmith
William V
WV
Tamborlane
Joyce M
JM
Lee
Michael J
MJ
Haller
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D016883:Diabetic Ketoacidosis / Q000453:epidemiology / Q000517:prevention & control*; D016903:Drug Monitoring; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000517:prevention & control*; D007003:Hypoglycemia / Q000453:epidemiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015994:Incidence; D007223:Infant; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
HbA1c or glycemic control; children; diabetes