The INNODIA Type 1 Diabetes Natural History Study : a European cohort of newly diagnosed children, adolescents and adults
© 2024. The Author(s)..
AIMS/HYPOTHESIS: Type 1 diabetes is an heterogenous condition. Characterising factors explaining differences in an individual's clinical course and treatment response will have important clinical and research implications. Our aim was to explore type 1 diabetes heterogeneity, as assessed by clinical characteristics, autoantibodies, beta cell function and glycaemic outcomes, during the first 12 months from diagnosis, and how it relates to age at diagnosis.
METHODS: Data were collected from the large INNODIA cohort of individuals (aged 1.0-45.0 years) newly diagnosed with type 1 diabetes, followed 3 monthly, to assess clinical characteristics, C-peptide, HbA1c and diabetes-associated antibodies, and their changes, during the first 12 months from diagnosis, across three age groups: <10 years; 10-17 years; and ≥18 years.
RESULTS: The study population included 649 individuals (57.3% male; age 12.1±8.3 years), 96.9% of whom were positive for one or more diabetes-related antibodies. Baseline (IQR) fasting C-peptide was 242.0 (139.0-382.0) pmol/l (AUC 749.3 [466.2-1106.1] pmol/l × min), with levels increasing with age (p<0.001). Over time, C-peptide remained lower in participants aged <10 years but it declined in all age groups. In parallel, glucose levels progressively increased. Lower baseline fasting C-peptide, BMI SD score and presence of diabetic ketoacidosis at diagnosis were associated with lower stimulated C-peptide over time. HbA1c decreased during the first 3 months (p<0.001), whereas insulin requirement increased from 3 months post diagnosis (p<0.001).
CONCLUSIONS/INTERPRETATION: In this large cohort with newly diagnosed type 1 diabetes, we identified age-related differences in clinical and biochemical variables. Of note, C-peptide was lower in younger children but there were no main age differences in its rate of decline.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:67 |
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| Enthalten in: |
Diabetologia - 67(2024), 6 vom: 23. Apr., Seite 995-1008 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Marcovecchio, M Loredana [VerfasserIn] |
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| Links: |
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| Themen: |
Age |
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| Anmerkungen: |
Date Completed 29.04.2024 Date Revised 29.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00125-024-06124-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Marcovecchio, M Loredana |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The INNODIA Type 1 Diabetes Natural History Study |b a European cohort of newly diagnosed children, adolescents and adults |
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| 500 | |a Date Revised 29.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a AIMS/HYPOTHESIS: Type 1 diabetes is an heterogenous condition. Characterising factors explaining differences in an individual's clinical course and treatment response will have important clinical and research implications. Our aim was to explore type 1 diabetes heterogeneity, as assessed by clinical characteristics, autoantibodies, beta cell function and glycaemic outcomes, during the first 12 months from diagnosis, and how it relates to age at diagnosis | ||
| 520 | |a METHODS: Data were collected from the large INNODIA cohort of individuals (aged 1.0-45.0 years) newly diagnosed with type 1 diabetes, followed 3 monthly, to assess clinical characteristics, C-peptide, HbA1c and diabetes-associated antibodies, and their changes, during the first 12 months from diagnosis, across three age groups: <10 years; 10-17 years; and ≥18 years | ||
| 520 | |a RESULTS: The study population included 649 individuals (57.3% male; age 12.1±8.3 years), 96.9% of whom were positive for one or more diabetes-related antibodies. Baseline (IQR) fasting C-peptide was 242.0 (139.0-382.0) pmol/l (AUC 749.3 [466.2-1106.1] pmol/l × min), with levels increasing with age (p<0.001). Over time, C-peptide remained lower in participants aged <10 years but it declined in all age groups. In parallel, glucose levels progressively increased. Lower baseline fasting C-peptide, BMI SD score and presence of diabetic ketoacidosis at diagnosis were associated with lower stimulated C-peptide over time. HbA1c decreased during the first 3 months (p<0.001), whereas insulin requirement increased from 3 months post diagnosis (p<0.001) | ||
| 520 | |a CONCLUSIONS/INTERPRETATION: In this large cohort with newly diagnosed type 1 diabetes, we identified age-related differences in clinical and biochemical variables. Of note, C-peptide was lower in younger children but there were no main age differences in its rate of decline | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Age | |
| 650 | 4 | |a Beta cell function | |
| 650 | 4 | |a C-peptide | |
| 650 | 4 | |a Prevention | |
| 650 | 4 | |a Subgroups | |
| 650 | 4 | |a Treatment | |
| 650 | 4 | |a Type 1 diabetes | |
| 650 | 7 | |a C-Peptide |2 NLM | |
| 650 | 7 | |a Autoantibodies |2 NLM | |
| 650 | 7 | |a Glycated Hemoglobin |2 NLM | |
| 650 | 7 | |a Blood Glucose |2 NLM | |
| 700 | 1 | |a Hendriks, A Emile J |e verfasserin |4 aut | |
| 700 | 1 | |a Delfin, Carl |e verfasserin |4 aut | |
| 700 | 1 | |a Battelino, Tadej |e verfasserin |4 aut | |
| 700 | 1 | |a Danne, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Evans, Mark L |e verfasserin |4 aut | |
| 700 | 1 | |a Johannesen, Jesper |e verfasserin |4 aut | |
| 700 | 1 | |a Kaur, Simranjeet |e verfasserin |4 aut | |
| 700 | 1 | |a Knip, Mikael |e verfasserin |4 aut | |
| 700 | 1 | |a Overbergh, Lut |e verfasserin |4 aut | |
| 700 | 1 | |a Pociot, Flemming |e verfasserin |4 aut | |
| 700 | 1 | |a Todd, John A |e verfasserin |4 aut | |
| 700 | 1 | |a Van der Schueren, Bart |e verfasserin |4 aut | |
| 700 | 1 | |a Wicker, Linda S |e verfasserin |4 aut | |
| 700 | 1 | |a Peakman, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Mathieu, Chantal |e verfasserin |4 aut | |
| 700 | 0 | |a INNODIA consortium |e verfasserin |4 aut | |
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