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P197 Evaluation of factors influencing partial remission in type 1 diabetes in children
  1. Cristina Maria Mihai1,2,
  2. Tatiana Chisnoiu
  1. 1 Paediatric Department for Diabetes, Nutrition, and Metabolic Disorders, Clinical County Emergency Hospital of Constanta
  2. 2 Paediatric Department, Ovidius University, Constanta

Abstract

Background and aims Type 1 diabetes is characterised by progressive autoimmune destruction of pancreatic beta cells in people with genetic susceptibility. This autoimmune process started years ago, before the first signs of diabetes appears. Due to residual pancreatic secretion of insulin, and growth tissue sensitivity to insulin, insulin requirements decrease temporary after initiation of insulin.

Methods This study consisted in evaluation factors that may influence partial remission in 45 patients between 5–15 years, with type 1 diabetes at onset, during 2013–2016. All patients were characterised by sex,age, duration of symptoms before diagnosis, ketoacidosis at diagnosis or absence, length of hospitalisation, C-peptide levels and HbA1c at diagnosis and daily insulin requirements/kg. The partial remission phase was defined as an insulin requirement of<0.5 units/kg of body weight per day and HbA1c<7% (ISPAD 2014).

Results Partial remission was seen in 25 patients (11.25%) aged between 10 and 15 years. Time between onset and remission were averaged 31.2 days (+/-9.8) and the mean duration of partial remission was 11.5 months (+/-28 days). 19 children in whom remission occurred hadn`t ketoacidosis at diagnosis and 6 were in ketoacidosis; their length of hospitalisation was between 3–5 days. Insulin requirements decreased after a 2–3 weeks of insulin intensive treatment especially in boys ( 83%) with increasing age. Elevated levels of C-peptide, lower HbA1c, and appear of symptoms shortly before diagnosis were also associated with a longer honeymoon.

Conclusions Because the preservation of beta cell function has an important role in developing acute complications such as severe hypoglycemia, is good to know the factors positively influencing the remission rate in newly diagnosed with type 1 diabetes patients.

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