Comparison of HbA1c results obtained by Quo-Test device
and Vitros 5,1 FS analyzer in children with type 1 diabetes.

Introduction: The increase in the prevalence of diabetes, considered as the disease of civilization, is a health and economic problem also in paediatric population. One of the main parameter for monitoring glycaemia is glycated haemoglobin (HbA1c). Determination of HbA1c concentration in blood can be performed on both biochemical analyzers and small devices used at the point of care testing (POCT). Validity of HbA1c results obtained in POCT system is continuously verified. Aim: Comparison of HbA1c results obtained by using Quo-Test device (EKF Diagnostics) and Vitros 5,1 FS analyzer (Diasorin). Materials and methods: The study included 98 children (48 boys, 50 girls) with type 1 diabetes. Diagnosis was done based on the criteria of Polish Diabetes Association (PTD). Venous K2EDTA blood was collected and the HbA1c level was determined on the Quo-Test device (method based on reaction with the boronic acid derivative) and Vitros 5,1 FS analyzer (turbidimetric method). Statistical analysis was performed using Statistica10 (StatSoft). Results: Statistically significantly higher HbA1c concentrations were noticed in the results obtained on Quo-Test compared to Vitros 5,1 FS for all the measurements of HbA1c (p=0.001) and for HbA1c <6.5% (p=0.001), for results HbA1c ≥6.5% obtained concentrations were significantly lower (p=0.014). Analysis of Passing-Bablock regression showed no difference between the methods for HbA1c <6.5%. For HbA1c ≥6.5%, as well as for all HbA1c results, regression coefficients did not confirm the comparability of the two methods. Mean bias ± 95% limits of agreement (LOA) was 0.14% [(-0.32) – 0.61]). The Bland-Altman index was equal to 5.15%. Conclusion: The Quo-Test device can be used only for monitoring HbA1c level in children with type 1 diabetes as long as it will not be used interchangeably with Vitros 5,1 FS.

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Factors associated with high levels of glycated haemoglobin in patients with type 1 diabetes: a multicentre study in Brazil

BMJ Open ◽

10.1136/bmjopen-2017-018094 ◽

2017 ◽

Vol 7 (12) ◽

pp. e018094 ◽

Cited By ~ 13

Author(s):

Carine Sousa Andrade ◽

Guilherme Sousa Ribeiro ◽

Carlos Antonio Souza Teles Santos ◽

Raimundo Celestino Silva Neves ◽

Edson Duarte Moreira

Keyword(s):

Type 1 Diabetes ◽

Glycaemic Control ◽

Hba1c Level ◽

Glycated Haemoglobin ◽

Poor Adherence ◽

Adherence To Diet ◽

The Mean ◽

Lower Education ◽

Hba1c Levels

ObjectiveLong-term complications of type 1 diabetes mellitus (DM1) can be prevented with adequate glycaemic control. However, high levels of glycated haemoglobin (HbA1c) occur in 60%–90% of the patients with DM1. Thus, we aimed to investigate the role of sociodemographic, behavioural and clinical factors on the HbA1c levels of patients with DM1 in Brazil.Design, setting and participantsA cross-sectional study was conducted in ambulatory patients with DM1 aged ≥18 years from 10 Brazilian cities. Sociodemographic, behavioural and clinical data were obtained through interviews.Main outcome measuresHbA1c level was measured by liquid chromatography. Hierarchical multiple variable linear regression models were used to identify factors correlated with high levels of HbA1c.ResultsOf 979 patients with DM1, 63.8% were women, and the mean age was 40 (SD 14.6) years. The mean HbA1c level was 9.4% (SD 2.2%), and 89.6% of the patients had HbA1c ≥7.0%. Factors independently correlated with increased HbA1c levels included: lower education, non-participation in diabetes classes/lecture during the year before, having a self-perception of poor adherence to diet and insulin, not having private medical care and not measuring the HbA1c levels in the prior year. Of note, poor adherence to diet and insulin were the independent factors most strongly associated with high levels of HbA1c (mean increment in HbA1c levels of 0.88% and 1.25%, respectively).ConclusionPoor glycaemic control, which is common among Brazilian patients with DM1, is associated with lower education, self-perception of insufficient adherence to diet and insulin and inadequate monitoring of HbA1c levels. Specific actions, particularly those targeting improving adherence to diet and insulin, may contribute to successful management of patients with DM1.

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The relationship between birth weight and maternal glycated haemoglobin (HbA1c) concentration in pregnancies complicated by Type 1 diabetes

Diabetic Medicine ◽

10.1046/j.1464-5491.2003.00868.x ◽

2003 ◽

Vol 20 (2) ◽

pp. 162-166 ◽

Cited By ~ 25

Author(s):

G. C. Penney ◽

G. Mair ◽

D. W. M. Pearson

Keyword(s):

Type 1 Diabetes ◽

Birth Weight ◽

Glycated Haemoglobin ◽

Hba1c Concentration ◽

The Relationship

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1316-P: Celiac Disease in Youth with Type 1 Diabetes: Association with Age at Diabetes Diagnosis

Diabetes ◽

10.2337/db20-1316-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 1316-P

Author(s):

ERIN ALVING ◽

KRISTEN CARLIN ◽

DALE LEE ◽

ALISSA J. ROBERTS ◽

JANE DICKERSON ◽

...

Keyword(s):

Type 1 Diabetes ◽

Celiac Disease ◽

Diabetes Diagnosis

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DR15-DQ6 remains dominantly protective against type 1 diabetes throughout the first five decades of life

Diabetologia ◽

10.1007/s00125-021-05513-4 ◽

2021 ◽

Author(s):

Nicholas J. Thomas ◽

John M. Dennis ◽

Seth A. Sharp ◽

Akaal Kaur ◽

Shivani Misra ◽

...

Keyword(s):

Type 1 Diabetes ◽

Major Type ◽

Diabetes Incidence ◽

Diabetes Diagnosis ◽

Risk Haplotype ◽

Adult Onset ◽

Uk Biobank ◽

Onset Type ◽

Increased Risk

Abstract Aims/hypothesis Among white European children developing type 1 diabetes, the otherwise common HLA haplotype DR15-DQ6 is rare, and highly protective. Adult-onset type 1 diabetes is now known to represent more overall cases than childhood onset, but it is not known whether DR15-DQ6 is protective in older-adult-onset type 1 diabetes. We sought to quantify DR15-DQ6 protection against type 1 diabetes as age of onset increased. Methods In two independent cohorts we assessed the proportion of type 1 diabetes cases presenting through the first 50 years of life with DR15-DQ6, compared with population controls. In the After Diabetes Diagnosis Research Support System-2 (ADDRESS-2) cohort (n = 1458) clinician-diagnosed type 1 diabetes was confirmed by positivity for one or more islet-specific autoantibodies. In UK Biobank (n = 2502), we estimated type 1 diabetes incidence rates relative to baseline HLA risk for each HLA group using Poisson regression. Analyses were restricted to white Europeans and were performed in three groups according to age at type 1 diabetes onset: 0–18 years, 19–30 years and 31–50 years. Results DR15-DQ6 was protective against type 1 diabetes through to age 50 years (OR < 1 for each age group, all p < 0.001). The following ORs for type 1 diabetes, relative to a neutral HLA genotype, were observed in ADDRESS-2: age 5–18 years OR 0.16 (95% CI 0.08, 0.31); age 19–30 years OR 0.10 (0.04, 0.23); and age 31–50 years OR 0.37 (0.21, 0.68). DR15-DQ6 also remained highly protective at all ages in UK Biobank. Without DR15-DQ6, the presence of major type 1 diabetes high-risk haplotype (either DR3-DQ2 or DR4-DQ8) was associated with increased risk of type 1 diabetes. Conclusions/interpretation HLA DR15-DQ6 confers dominant protection from type 1 diabetes across the first five decades of life. Graphical abstract

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Diabetic cardiovascular autonomic neuropathy in children

European Heart Journal ◽

10.1093/ehjci/ehaa946.3200 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

O.L.G.A Gumeniuk ◽

N Bolotova ◽

A Averianov ◽

I.U Chernenkov

Keyword(s):

Heart Rate ◽

Type 1 Diabetes ◽

Autonomic Neuropathy ◽

Hba1c Level ◽

Diabetes Duration ◽

Cardiovascular Autonomic Neuropathy ◽

Deep Breath ◽

Group I ◽

Diabetic Cardiovascular Autonomic Neuropathy

Abstract Diabetic cardiovascular autonomic neuropathy (CAN) encompasses damage to the autonomic nerve fibers innervating the heart and blood vessels, resulting in abnormalities in heart rate control and vascular dynamics. Clinical symptoms associated with CAN include resting tachycardia, postural hypotension, dizziness, syncope, exercise intolerance, silent myocardial infarction. The earliest finding of CAN, even at the subclinical stage, is a decrease in heart rate variability (HRV) Purpose To study CAN prevalence and understand the diagnostic capabilities of HRV - tests of diabetic cardiovascular autonomic neuropathy in children with type 1 diabetes. Methods 100 children with type 1 diabetes were assessed for CAN (age 15.2 yrs [9.0–17.8], duration 6.5 yrs [4.0–10.6], HbA1c 8.1% 6.3–9.7]). The degree of compensation of diabetes was estimated according to criteria ISPAD Consensus Guidelines, 2018. Optimal level (HbA1c <7.0%) of compensation was revealed in 62% of children (group I) and nonoptimal in 38% of children (group II). For evaluation of the CAN we used HRV - tests: RR 30:15 ratio, ΔRR quiet breath, ΔRR deep breath, BP response to standing. Results Diabetic cardiovascular autonomic neuropathy was diagnosed in 41 children: in group I – in 6 (29%) and in group II – 35 (71%) children (p=0.00001). The prevalence of DCN correlated with HbA1c level in children and adolescents (groups I and II): ΔRR quiet breath r=−0.47 & r=−0.9; ΔRR deep breath r=−0.65 & r=−0.85; RR30:15 r=−0.77 & r=−0.88 respectively. Prevalence of CAN increased parallel to type 1 diabetes duration (p<0.01). Conclusions Diabetic cardiovascular autonomic neuropathy in children with type 1 diabetes was diagnosed in 41%. Prevalence of diabetic cardiovascular autonomic neuropathy increases parallel to type 1 diabetes duration (p<0.01). In this study we found an association between HRV indexes and HbA1c level. This provides support for HRV - testing to assess diabetic cardiovascular autonomic neuropathy in children. Funding Acknowledgement Type of funding source: None

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Prevalence of autoantibodies in type 1 diabetes mellitus pediatrics in Mazandaran, North of Iran

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0396 ◽

2020 ◽

Vol 33 (10) ◽

pp. 1299-1305

Author(s):

Daniel Zamanfar ◽

Mohsen Aarabi ◽

Monireh Amini ◽

Mahila Monajati

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Serum Level ◽

Type 1 Diabetes Mellitus ◽

Children And Adolescents ◽

Statistical Significance ◽

Pancreatic Beta Cell ◽

Eligible Patient ◽

Diabetes Diagnosis

AbstractObjectivesType 1 diabetes is an autoimmune disease. Its most important immunologic markers are pancreatic beta-cell autoantibodies. This study aimed to determine diabetes mellitus antibodies frequency among children and adolescents with type 1 diabetes.MethodsThis descriptive study evaluated the frequency of four diabetes autoantibodies (glutamic acid decarboxylase 65 autoantibodies [GADA], islet cell autoantibodies [ICA], insulin autoantibodies [IAA], tyrosine phosphatase–like insulinoma antigen-2 antibodies [IA-2A]) and their serum level in children and adolescents diagnosed with type 1 diabetes mellitus at the diabetes department of Bou-Ali-Sina Hospital and Baghban Clinic, Sari, Iran, from March 2012 to March 2018. The relationship between the level of different antibodies and age, gender, and diabetes duration were determined. A two-sided p value less than 0.05 indicated statistical significance.ResultsOne hundred forty-two eligible patient records were screened. The average age at diabetes diagnosis was 4.2 ± 4.4 years. The median duration of diabetes was 34.0 (12.7–69.7) months. 53.5% of patients were female, and 81.7% of them had at least one positive autoantibody, and ICA in 66.2%, GADA in 56.3%, IA-2A in 40.1%, and IAA in 21.8% were positive. The type of the autoantibodies and their serum level was similar between females and males but there was a higher rate of positive autoantibodies in females. The level of IA-2A and ICA were in positive and weak correlation with age at diagnosis.ConclusionsMore than 80% of pediatric and adolescent patients with type 1 diabetes were autoantibody-positive. ICA and GADA were the most frequently detected autoantibodies. The presence of antibodies was significantly higher in females.

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Continuous subcutaneous insulin infusion alters microRNA expression and glycaemic variability in children with type 1 diabetes

Scientific Reports ◽

10.1038/s41598-021-95824-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Emma S. Scott ◽

Andrzej S. Januszewski ◽

Luke M. Carroll ◽

Gregory R. Fulcher ◽

Mugdha V. Joglekar ◽

...

Keyword(s):

Type 1 Diabetes ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Diabetes Diagnosis ◽

Subcutaneous Insulin ◽

Glycaemic Variability ◽

Altered Expression ◽

C Peptide

AbstractTo determine whether continuous subcutaneous insulin infusion (CSII) vs. multiple daily injections (MDI) therapy from near-diagnosis of type 1 diabetes is associated with reduced glycaemic variability (GV) and altered microRNA (miRNAs) expression. Adolescents (74% male) within 3-months of diabetes diagnosis (n = 27) were randomized to CSII (n = 12) or MDI. HbA1c, 1-5-Anhydroglucitol (1,5-AG), high sensitivity C-peptide and a custom TaqMan qPCR panel of 52 miRNAs were measured at baseline and follow-up (median (LQ-UQ); 535 (519–563) days). There were no significant differences between groups in baseline or follow-up HbA1c or C-peptide, nor baseline miRNAs. Mean ± SD 1,5-AG improved with CSII vs. MDI (3.1 ± 4.1 vs. − 2.2 ± − 7.0 mg/ml respectively, P = 0.029). On follow-up 11 miRNAs associated with diabetes vascular complications had altered expression in CSII-users. Early CSII vs. MDI use is associated with lower GV and less adverse vascular-related miRNAs. Relationships with future complications are of interest.

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