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- Titel:
Fasting hypoglycemia is associated with disease progression in presymptomatic early stage type 1 diabetes.
- Dokumenttyp:
- Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
- Autor(en):
- Heinrich, Melanie; Maison, Nicole; Achenbach, Peter; Assfalg, Robin; Braig, Sonja; Böcker, Dominik; Dunstheimer, Désirée; Ermer, Uwe; Gavazzeni, Antonia; Gerstl, Eva-Maria; Hummel, Sandra; Kick, Kerstin; Müller, Herbert; Nellen-Hellmuth, Nicole; Ockert, Christian; Sindichakis, Marina; Tretter, Stefanie; Warncke, Katharina; Ziegler, Anette-Gabriele; Beyerlein, Andreas
- Abstract:
- OBJECTIVE: In children with presymptomatic type 1 diabetes, intermittent hyperglycemia and rising hemoglobin A1c levels are a known signal of progression toward insulin-dependency. Episodes of hypoglycemia, however, have also been reported in one published case. We investigated the prevalence of hypoglycemia and its association with disease progression in children with presymptomatic type 1 diabetes. METHODS: We compared the frequency of hypoglycemic fasting blood glucose levels (<60 mg/dL) in 48 autoantibody negative and 167 multiple β-cell autoantibody positive children aged 2 to 5 years. We classified the autoantibody positive children into three categories based on their glucose levels in fasting state (hypoglycemic [<60 mg/dL], normoglycemic [60-99 mg/dL] or hyperglycemic [≥100 mg/dL]). We then compared the glucose levels under challenge during oral glucose tolerance tests (OGTTs) between the three categories. RESULTS: In the autoantibody positive children, 5.1% of the fasting samples were hypoglycemic, while in the autoantibody negative children no hypoglycemia was observed. Hypoglycemia occurred more often in autoantibody positive children who had already entered stage 2 or stage 3 of type 1 diabetes than in stage 1 patients (P = 0.02). Children who had hypoglycemic compared to normoglycemic fasting blood glucose values had higher 120-minute blood glucose values under OGTT challenge, and a higher rate of pathological OGTTs (P = 0.04). CONCLUSIONS: Fasting hypoglycemia seems to be an indicator of disease progression in presymptomatic type 1 diabetes and may therefore represent a novel marker for the identification of children who should be monitored more closely for progression toward insulin-dependent type 1 diabetes.
- Zeitschriftentitel:
- Pediatr Diabetes
- Jahr:
- 2018
- Band / Volume:
- 19
- Heft / Issue:
- 7
- Seitenangaben Beitrag:
- 1238-1242
- Volltext / DOI:
- doi:10.1111/pedi.12739
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/30098103
- Print-ISSN:
- 1399-543X
- TUM Einrichtung:
- Klinik und Poliklinik für Kinderheilkunde und Jugendmedizin
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