Influence of the occurrence and duration of partial remission on short-term metabolic control in type 1 diabetes: the DIABHONEY pediatric study

OBJECTIVE: To evaluate the residual effect of partial remission (PR) on immediate post-PR glycemic control according to its occurrence and duration in a cohort of children with type 1 diabetes mellitus (T1DM). PATIENTS AND METHODS: Values of glycemic control parameters [i.e. HbA(1C), insulin dose–adjusted hemoglobin A(1C) (IDAA(1C)), glycemic target–adjusted HbA(1C) (GTAA(1C))] and data from glucose monitoring devices from 189 pediatric patients with new-onset type 1 diabetes were collected retrospectively from 24 months. Patients were characterized according to their remission status (PR(+) and PR(−)). PR(+) patients were subdivided into three subgroups regarding PR duration [i.e. short (⩾3–⩽6 months), intermediate (>6–⩽12 months), and long PR (>12–⩽14 months)]. We compared glycemic control data from each PR(+) subgroup at +6 and +12 months post-PR with PR(−) patients at the same postdiagnosis time. Second, PR(+) subgroups were compared with each other. RESULTS: PR(+) patients showed improved glycemic control (i.e. HbA(1C), IDAA(1C), and GTAA(1C)) at + 6 months post-PR when compared with nonremitters (PR(−)), independently of the PR duration subgroups (p < 0.05). Interestingly, patients in long PR(+) subgroup exhibited higher positive residual effect than short PR(+) subgroup with lower GTAA(1C) scores (p = 0.02), better time in range (TIR) (p = 0.003), less time in hypoglycemia (10.45 versus 16.13%, p = 0.03) and less glycemic variability (83.1 mg/dl versus 98.84 mg/dl, p = 0.03). No significant differences were found for glucose control between PR(+) and PR(−) patients at +12 months post-PR. CONCLUSION: This study supports the positive impact of PR occurrence and duration on short-term metabolic control (better HbA(1C) levels, IDAA(1C) and GTAA(1C) scores, TIR, and less glycemic variability) with the residual effect increasing according to PR duration.