Abstract
In 477 children with IDD treated conventionally, glycosylated hemoglobin(GHb),blood glucose(BG) & C-peptide(CP)were measured 2-3 hr.postprandially over a lyr period as indicators of metabolic control to assess the effects of pt. age,sex,disease duration, & in a subgroup of 273,no. of daily injections & dose of insulin. The mean±SEM %GHb over this period was 11.8±.2% & BG 237±9 mg/dl. Only 13(2.7%)had a normal %GHb(≤7.5%).There was a highly significant correlation(p<0.001)between %GHb & both age & BG,but not with sex or duration >lyr.In 321 IDD children evaluated more than once %GHbremained within ±.5% of the initial value in 17%,decreased in 53%, & increased in 30%.There was no relationship between %GHb & no.of daily injections or dose of insulin.There was no seasonal variation. In 150, GHb was measured in RBCs both without (routine) & with incubation 1:10 in normal saline to assess the labile&stable forms of GHb respectively.%GHb was 11.6±.2% & 10.1±.1%respectively (r=.91,p<0.001).Correlation to BGremained significant in both, though less in the saline-incubated specimens(r=.54&.37respectively).CP levels did not correlate with %GHb in either the remission or later stages.Because of the closer correlation of %GHb to age than to other factors such as disease duration,we suggest that hormonal&compliance factors during puberty may be more important determinants than residual β-cell function in achieving good metabolic control.Our ability to improve control over the short term has been quite limited.This study may help target those IDD children requiring more aggressive therapy.
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Daneman, D., Wolfson, D., Becker, D. et al. 1113 FACTORS AFFECTING METABOLIC CONTROL IN CHILDREN WITH INSULIN-DEPENDENT DIABETES(IDD). Pediatr Res 15 (Suppl 4), 628 (1981). https://doi.org/10.1203/00006450-198104001-01139
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DOI: https://doi.org/10.1203/00006450-198104001-01139
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