Ramos Maria E N, Leão Isabella S, Vezzani Joana R D, Campos Ludmila N R, Luescher Jorge L, Berardo Renata S, Zajdenverg Lenita, Rodacki Melanie
Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brazil.
Universidade Federal do Rio de Janeiro, Departamento de Medicina Interna, Rio de Janeiro, RJ, Brazil.
J Pediatr (Rio J). 2025 Mar-Apr;101(2):167-171. doi: 10.1016/j.jped.2024.09.005. Epub 2024 Nov 4.
To assess the frequency and potential influencing factors of the remission phase (RP) in Type 1 Diabetes (T1D) as well as the associations between various criteria used for its definition.
This was a retrospective cohort study based on data collected from medical records. Three criteria were used to evaluate RP: (1) Glycated hemoglobin (HbA1c) < 7.5 % with an insulin dose < 0.5 U/Kg/day, (2) HbA1c < 7 % with an insulin dose < 0.5 U/Kg/day, and (3) Insulin Dose Adjusted A1c (IDAA1c) ≤ 9, calculated as IDAA1c = HbA1c (%) + [4 x insulin dose (U/Kg/day)]. Statistical analyses included the Mann-Whitney U Test, Chi-Square Test, and Spearman Correlation.
The sample consisted of 144 T1D patients, with a mean age of 26.22 ± 8.30 years and a mean age of onset of 13.30 ± 8.50 years. Of these, 52.9 % were female, 60.3 % were Caucasoid, and 31 % experienced diabetic ketoacidosis (DKA) at disease onset. One year after diagnosis, the occurrence of RP ranged from 27.2 % to 46.8 %, depending on the criteria used. Three patients experienced RP even after seven years, according to criterion 3. No association was found between RP and age, DKA, or pubertal status at onset. The three RP criteria were highly associated with each other (p < 0.001).
A significant proportion of patients in this sample experienced RP within 12 months of diagnosis. The three criteria for defining RP were strongly associated, indicating their reliability in both clinical and research contexts.
评估1型糖尿病（T1D）缓解期（RP）的发生频率及潜在影响因素，以及用于定义缓解期的各种标准之间的关联。
这是一项基于病历收集数据的回顾性队列研究。采用三个标准评估缓解期：（1）糖化血红蛋白（HbA1c）<7.5%且胰岛素剂量<0.5U/Kg/天；（2）HbA1c<7%且胰岛素剂量<0.5U/Kg/天；（3）胰岛素剂量调整糖化血红蛋白（IDAA1c）≤9，计算方法为IDAA1c = HbA1c（%）+[4×胰岛素剂量（U/Kg/天）]。统计分析包括曼-惠特尼U检验、卡方检验和斯皮尔曼相关性分析。
样本包括144例T1D患者，平均年龄26.22±8.30岁，平均发病年龄13.30±8.50岁。其中，52.9%为女性，60.3%为白种人，31%在疾病发作时经历过糖尿病酮症酸中毒（DKA）。诊断后一年，根据所使用的标准，缓解期的发生率在27.2%至46.8%之间。根据标准3，三名患者甚至在七年之后仍处于缓解期。未发现缓解期与发病时的年龄、DKA或青春期状态之间存在关联。三个缓解期标准彼此高度相关（p<0.001）。
该样本中有很大比例的患者在诊断后12个月内经历了缓解期。定义缓解期的三个标准密切相关，表明它们在临床和研究背景下均具有可靠性。
