Browsing by Author "Schwandt, A"
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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.
- A Description of Clinician Reported Diagnosis of Type 2 Diabetes and Other Non-Type 1 Diabetes Included in a Large International Multicentered Pediatric Diabetes Registry (SWEET)Publication . Pacaud, D; Schwandt, A; de Beaufort, C; Casteels, K; Beltrand, J; Birkebaek, N; Campagnoli, M; Bratina, N; Limbert, C; Mp O'Riordan, S; Ribeiro, R; Gerasimidi-Vazeou, A; Petruzelkova, L; Verkauskiene, R; Krisane, IDAlthough type 1 diabetes (T1D) remains the most frequent form of diabetes in individuals aged less than 20 years at onset, other forms of diabetes are being increasingly recognized.
- 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.
- Prevalence of Underweight, Overweight, and Obesity in Children and Adolescents with Type 1 Diabetes: Data From the International SWEET RegistryPublication . Maffeis, C; Birkebaek, NH; Konstantinova, M; Schwandt, A; Vazeou, A; Casteels, K; Jali, S; Limbert, C; Pundziute-Lycka, A; Toth-Heyn, P; de Beaufort, C; Sumnik, Z; Cherubini, V; Svensson, J; Pacaud, D; Kanaka-Gantenbein, C; Shalitin, S; Bratina, N; Hanas, R; Alonso, GT; Poran, L; Pereira, AL; Marigliano, MObjective: To assess the prevalence of underweight (UW), overweight (OW), and obesity in children and adolescents with type 1 diabetes (T1D). Methods: An international cross-sectional study including 23 026 T1D children (2-18 years, duration of diabetes ≥1 year) participating in the SWEET prospective, multicenter diabetes registry. Body mass index SD score (BMI-SDS) was calculated using the World Health Organization BMI charts. Children were categorized as UW (BMI-SDS < -2SD), OW (+1SD < BMI-SDS ≤ +2SD), and obese (OB) (BMI-SDS > +2SD). Hierarchic regression models were applied with adjustment for sex, age, and duration of diabetes. Results: The prevalence of UW, OW, and obesity was: 1.4%, 22.3%, and 7.3% in males and 0.6%, 27.2%, and 6.8% in females. Adjusted BMI-SDS was significantly higher in females than in males (mean ± SEM: 0.54 ± 0.05 vs 0.40 ± 0.05, P < 0.0001). In males, BMI-SDS significantly decreased by age (P < 0.0001) in the first three age categories 0.61 ± 0.06 (2 to <10 years), 0.47 ± 0.06 (10 to <13 years), 0.34 ± 0.05 (13 to <16 years). In females, BMI-SDS showed a U-shaped distribution by age (P < 0.0001): 0.54 ± 0.04 (2 to <10 years), 0.39 ± 0.04 (10 to <13 years), 0.55 ± 0.04 (13 to <16 years). BMI-SDS increased by diabetes duration (<2 years: 0.38 ± 0.05, 2 to <5 years: 0.44 ± 0.05, and ≥5 years: 0.50 ± 0.05, P < 0.0001). Treatment modality did not affect BMI-SDS. Adjusted HbA1c was significantly higher in females than in males (8.20% ± 0.10% vs 8.06% ± 0.10%, P < 0.0001). In both genders, the association between HbA1c and BMI-SDS was U-shaped with the highest HbA1c in the UW and obesity groups. Conclusions: The high rate of OW and obesity (31.8%) emphasize the need for developing further strategies to prevent and treat excess fat accumulation in T1D.