Browsing by Author "Cardona-Hernandez, R"
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- Association of Diabetic Ketoacidosis and HbA1c at Onset with Year-Three HbA1c in Children and Adolescents with Type 1 Diabetes: Data from the International SWEET RegistryPublication . Piccini, B; Schwandt, A; Jefferies, C; Kordonouri, O; Limbert, C; Arslanoglu, I; Cardona-Hernandez, R; Coutant, R; Kim, JH; Preiksa, RT; Pundziute Lyckå, A; Rami-Merhar, B; Richmond, E; Savova, R; Todorovic, S; Veeze, HJ; Toni, SObjective: To establish whether diabetic ketoacidosis (DKA) or HbA1c at onset is associated with year-three HbA1c in children with type 1 diabetes (T1D). Methods: Children with T1D from the SWEET registry, diagnosed <18 years, with documented clinical presentation, HbA1c at onset and follow-up were included. Participants were categorized according to T1D onset: (a) DKA (DKA with coma, DKA without coma, no DKA); (b) HbA1c at onset (low [<10%], medium [10 to <12%], high [≥12%]). To adjust for demographics, linear regression was applied with interaction terms for DKA and HbA1c at onset groups (adjusted means with 95% CI). Association between year-three HbA1c and both HbA1c and presentation at onset was analyzed (Vuong test). Results: Among 1420 children (54% males; median age at onset 9.1 years [Q1;Q3: 5.8;12.2]), 6% of children experienced DKA with coma, 37% DKA without coma, and 57% no DKA. Year-three HbA1c was lower in the low compared to high HbA1c at onset group, both in the DKA without coma (7.1% [6.8;7.4] vs 7.6% [7.5;7.8], P = .03) and in the no DKA group (7.4% [7.2;7.5] vs 7.8% [7.6;7.9], P = .01), without differences between low and medium HbA1c at onset groups. Year-three HbA1c did not differ among HbA1c at onset groups in the DKA with coma group. HbA1c at onset as an explanatory variable was more closely associated with year-three HbA1c compared to presentation at onset groups (P = .02). Conclusions: Year-three HbA1c is more closely related to HbA1c than to DKA at onset; earlier hyperglycemia detection might be crucial to improving year-three HbA1c.
- Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registryPublication . Szypowska, A; Schwandt, A; Svensson, J; Shalitin, S; Cardona-Hernandez, R; Forsander, G; Sundberg, F; De Beaufort, C; Maahs, D; Maffeis, C; O'Riordan, S; Krisane, ID; Scharf, M; Castro, S; Konstantinova, M; Obermannova, B; Casteels, K; Gökşen, D; Galhardo, J; Kanaka-Gantenbein, C; Rami-Merhar, B; Madacsy, LIntensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control.
- The COVID-19 Pandemic Affects Seasonality, With Increasing Cases of New-Onset Type 1 Diabetes in Children, From the Worldwide SWEET RegistryPublication . Reschke, F; Lanzinger, S; Herczeg, V; Prahalad, P; Schiaffini, R; Mul, D; Clapin, H; Zabeen, B; Pelicand, J; Phillip, M; Limbert, C; Danne, T; Alonso, GT; Rhodes, ET; Davis, E; Veeze, HJ; Maahs, D; Cardona-Hernandez, R; Sumnik, Z; Corathers, S; Bratina, N; Danne, T; Gevers, E; Imane, Z; Piccini, B; Forsander, G; Pacaud, D; Maffeis, C; Campbell, F; Bonfanti, R; de Sanctis, L; Krone, RE; Toth-Heyn, P; Witsch, M; Arsanoglu, I; Jefferies, C; Landry, A; Beltrand, J; Amed, S; Rami-Merhar, B; Barat, P; Szypowska, A; Zabeen, B; Casteels, K; Savova, R; Cherubini, V; de Bock, M; Todorovic, S; Limbert, C; Moravej, H; Pozgaj Sepac, M; Mazur, A; Gerasimidou-Vazeou, A; Iotova, V; O’Riordan, S; Chobot, A; Herbst, A; Ngwu, U; Cody, D; Birkebæk, NH; Hanas, R; Goksen, D; Sarda, A; Chobot, J; Mirante, A; Richmond Padilla, E; Tsiroukidou, K; Saboo, B; Kanaka-Gantenbein, C; Schiaffini, R; Foskett, D; Jali, S; Verkauskiene, R; Castro-Correia, C; Kumar Guness, P; Pelicand, J; Cotterill, A; Kumari Mohan, M; Spehar Uroic, A; Goss, P; Svensson, J; Ramchandani, GD; Coutant, R; Mantilla, L; Sima, A; Hyun Kim, J; Galli-Tsinopoulou, A; Ribeiro, R; O’Gorman, C; Fonna, H; Bratke, H; El Habashy, S; Gokalani, R; Scharf Pinto, M; Chavda, VObjective: To analyze whether the coronavirus disease 2019 (COVID-19) pandemic increased the number of cases or impacted seasonality of new-onset type 1 diabetes (T1D) in large pediatric diabetes centers globally. Research design and methods: We analyzed data on 17,280 cases of T1D diagnosed during 2018-2021 from 92 worldwide centers participating in the SWEET registry using hierarchic linear regression models. Results: The average number of new-onset T1D cases per center adjusted for the total number of patients treated at the center per year and stratified by age-groups increased from 11.2 (95% CI 10.1-12.2) in 2018 to 21.7 (20.6-22.8) in 2021 for the youngest age-group, <6 years; from 13.1 (12.2-14.0) in 2018 to 26.7 (25.7-27.7) in 2021 for children ages 6 to <12 years; and from 12.2 (11.5-12.9) to 24.7 (24.0-25.5) for adolescents ages 12-18 years (all P < 0.001). These increases remained within the expected increase with the 95% CI of the regression line. However, in Europe and North America following the lockdown early in 2020, the typical seasonality of more cases during winter season was delayed, with a peak during the summer and autumn months. While the seasonal pattern in Europe returned to prepandemic times in 2021, this was not the case in North America. Compared with 2018-2019 (HbA1c 7.7%), higher average HbA1c levels (2020, 8.1%; 2021, 8.6%; P < 0.001) were present within the first year of T1D during the pandemic. Conclusions: The slope of the rise in pediatric new-onset T1D in SWEET centers remained unchanged during the COVID-19 pandemic, but a change in the seasonality at onset became apparent.