title: Comorbidity of type 1 diabetes and juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To analyze the prevalence of juvenile idiopathic arthritis (JIA) and diabetes end points in pediatric patients with type 1 diabetes.
  
  
  METHODS
  Patients with type 1 diabetes, recorded from 1995 up to September 2013 in the Diabetes Patienten Verlaufsdokumentation database (n = 54,911, <16 years of age, 47% girls), were analyzed. The patients' height, weight, and body mass index SDS, glycosylated hemoglobin A1c (HbA1c); insulin dose; hypertension and dyslipidemia prevalence; rate of hypoglycemic events; and ketoacidosis were compared between patients with and without JIA. To adjust for age, sex, diabetes duration, and migration background, data were analyzed in hierarchic multivariable regression models.
  
  
  RESULTS
  The prevalence of JIA in type 1 diabetes was 106 of 54,911 patients; 66% were girls. Diabetes onset was earlier in children with JIA (7.2 years vs 8.3 years, P = .04). Children with JIA were smaller (SDS: -0.22 vs 0.09, P = .004). Correspondingly, weight SDS was lower in patients with JIA (-0.02 vs 0.22, P = .01). Body mass index SDS did not differ. HbA1c was marginally lower in children with JIA (63 mmol/mol [8.0%] vs 67 mmol/mol [8.3%], P = .06). Insulin requirement was greater in patients with JIA (1.03 vs 0.93 insulin units/weight/day, P = .003). Hypertension and dyslipidemia were comparable in both groups.
  
  
  CONCLUSIONS
  The JIA-prevalence in patients with type 1 diabetes (0.19%) was considerably greater than in the general population (0.05%). Growth is influenced negatively by JIA. Surprisingly, HbA1c was somewhat lower in children with JIA, possibly because of a more intensive treatment or a latent hemolysis caused by the inflammation.
authors: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany. Electronic address: reinhard.holl@uni-ulm.de.
authors: Gerhard
authors: G
authors: Hermann
authors: Department of Pediatric Pneumology, Allergology & Neonatology, Children's Hospital, Hanover Medical School, Hanover, Germany.
authors: Angelika
authors: A
authors: Thon
authors: Children's Hospital, Hospitals of the City of Cologne, Cologne, Germany.
authors: Kirsten
authors: K
authors: Mönkemöller
authors: Department of Pediatrics, Ruhr University of Bochum, Bochum, Germany.
authors: Eggert
authors: E
authors: Lilienthal
authors: Pediatric Practice, Herford, Germany.
authors: Christof
authors: C
authors: Klinkert
authors: Department of Pediatric Endocrinology and Diabetology, Olgahospital, Stuttgart Clinical Center, Stuttgart, Germany.
authors: Martin
authors: M
authors: Holder
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
authors: Thomas
authors: T
authors: Hörtenhuber
authors: German Center for Pediatric and Adolescent Rheumatology with Center for Social Pediatrics, Garmisch-Partenkirchen, Germany.
authors: Petra
authors: P
authors: Vogel-Gerlicher
authors: Hospital for Children and Adolescents, Sana Hospital Lichtenberg, Berlin Lichtenberg, Germany.
authors: Holger
authors: H
authors: Haberland
authors: Department of Pediatrics and Adolescent Medicine, Kassel Clinical Center, Kassel, Germany.
authors: Martin
authors: M
authors: Schebek
authors: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
authors: Reinhard W
authors: RW
authors: Holl
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000097:blood / Q000453:epidemiology*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity / Q000639:trends; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D006442:Glycated Hemoglobin