Little is known about complete remission in Type 1 diabetes mellitus (T1D) with the discontinuance of insulin treatment for a period of time. In this retrospective study we analysed the frequency and factors of onset and duration of 1. remission and 2. complete remission in children and adolescents with T1D from the Children Diabetes Centre in Bratislava, Slovakia. A total of 529 individuals with T1D, aged < 19 years (8.5 ± 4.3 years) at diabetes onset were included in the study. Remission was defined by HbA1c < 7.0% (53 mmol/mol) and an insulin daily dose < 0.5 IU/kg (and 0 IU/kg for complete remission). Remission occurred in 210 (39.7%) participants, and 15 of them had complete remission (2.8% from all participants). We have identified a new independent factor of complete remission onset (higher C-peptide). Complete remitters had a longer duration of remission compared with other remitters and also differed in lower HbA1c levels. No association was seen with autoantibodies or genetic risk score for T1D. Thus, not only partial but also complete remission is influenced by factors pointing toward an early diagnosis of T1D, which is important for better patient outcome.

detská klinika, lekárska fakulta univerzity komenského a národný ústav detských chorôb, Bratislava diaBGene a oddelenie výskumu porúch metabolizmu, Ústav experimentálnej endokrinológie, Biomedicínske centrum slovenskej akadémie vied, Bratislava

The implementation of modern technology into standard of care of type 1 diabetes lenka petruželková, lukáš plachý, marie kajprová, Vítek neuman, Barbora obermannová, Štěpánka průhová, Jan lebl, stanislava koloušková, Zdeněk Šumník pediatrická klinika Fn Motol a 2. lF uk, praha souhrn petruželková l, plachý l, kajprová m, neuman V, obermannová B, průhová Š, lebl J, koloušková s, Šumník Z. technologická revoluce v léčbě diabetu 1. typu diabetes 1. typu je chronické autoimunitní onemocnění vyžadující doživotní aplikaci inzulinu. Vzhledem k nárůstu počtu onemocnění především v nejmladší věkové kategorii je potřeba počítat s nárůstem celkového počtu pacientů a z toho plynoucí zvýšenou zátěží zdravotního systému. neuspokojivá kompenzace diabetu je spojena s rozvojem dlouhodobých mikro-a makrovaskulárních komplikací, které výrazně ovlivňují kvalitu a délku života pacientů. cílem léčby u dětských pacientů je dosáhnout optimální kontroly glykemie, tedy normoglykemie, která by měla výskyt sekundárních komplikací diabetu zcela eliminovat. k dosažení normoglykemie přispělo zařazení moderních technologií do standardní terapie diabetu 1. typu. Jejich přehled a cestu k našim pacientům přiblíží tento článek. klíčová slova: diabetes 1. typu, technologie, uzavřená smyčka summary petruželková l, plachý l, kajprová m, neuman V, obermannová B, průhová Š, lebl J, koloušková s, Šumník Z. the implementation of modern technology into standard of care of type 1 diabetes type 1 diabetes is a chronic autoimmune condition that requires life-long insulin administration. an increasing prevalence of diabetes, especially in youngest children, results in significant burden on the healthcare system. unsatisfactory disease control is associated with the development of long-term micro-and macrovascular complications, which significantly affect the quality of life and life expectancy of our patients. the current treatment goal in paediatric patients is to achieve normoglycemia and to completely eliminate the occurrence of secondary complications of diabetes. Modern technologies have been successfully implemented as the standard of care for people with type 1 diabetes and have improved the glycaemic control by reducing time spent both in hyper-and hypoglycaemia, while improving quality of life of our patients. their overview and their pathway to our patients are presented in this review.

Skin autofluorescence (SAF) is a noninvasive method reflecting tissue accumulation of advanced glycation end products (AGEs). We investigated whether, in newly diagnosed children and adolescents with type 1 diabetes (T1D), this surrogate marker of long-term glycemia is associated with markers of the early manifestation phase, residual secretion capacity of the ß-cells, and the occurrence of remission. SAF was measured in 114 children and adolescents (age: 8.0 ± 4.5 years, 44% girls) at the time of T1D diagnosis, and related to HbA1c, C-peptide, diabetic ketoacidosis, and remission. 56 patients were followed up for 1 year. Seventy-four sex- and age-matched healthy individuals served as controls. SAF was higher in the T1D group compared with controls (1.0 ± 0.2 vs. 0.9 ± 0.2, p < 0.001). At the time of diagnosis, SAF correlated with HbA1c (r = 0.285, p = 0.002), was similar in patients with and without ketoacidosis, and was lower in the remitters compared with non-remitters (0.95 ± 0.18 vs. 1.04 ± 0.26, p = 0.027). Unlike HbA1c, SAF was an independent predictor of remission (∆R2 = 0.051, p = 0.004). Former studies consider SAF in diabetic patients as a tool to identify individuals at an increased risk of chronic complications. Here we show that determination of SAF at the time of T1D diagnosis might potentially predict remission, at least in children.

Salivary urea is studied as a non-invasive alternative for screening and monitoring of renal diseases. Its high variability prevents a wider clinical use. Animal experiments are needed to identify factors affecting this marker. The aim of this study was to describe the inter-individual variability of salivary urea in healthy mice, establish reference intervals, and analyse the effects of sex, age and body weight. Plasma and saliva samples were obtained from 37 male and 41 female healthy adult CD1 mice aged 13–69 weeks (body weight 22–51 g). The reference interval for salivary urea in heathy mice based on our results is 2.7–8.4 mmol/l (CV = 23 %). Multivariate analysis did not show any significant effect of age, sex, or body weight. In addition, salivary urea did not correlate with its plasma concentrations. The high variability of the promising salivary marker of kidney function in healthy mice requires further research before its use to diagnose or monitor renal failure in animal models of kidney diseases. Other potential confounders should be analysed, including intra-individual and pre-analytical variability. In addition, a normalization factor such as total salivary proteins or salivation rate is likely needed.