Three-Variate Longitudinal Patterns of Metabolic Control, Body Mass Index, and Insulin Dose during Puberty in a Type 1 Diabetes Cohort: A Group-Based Multitrajectory Analysis.
Adolescent
Adult
Bayes Theorem
Blood Glucose
/ metabolism
Body Mass Index
Child
Diabetes Mellitus, Type 1
/ blood
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Glycated Hemoglobin
/ metabolism
Humans
Hypoglycemic Agents
/ administration & dosage
Insulin
/ administration & dosage
Male
Prospective Studies
Registries
Time Factors
Treatment Outcome
Young Adult
HbA1c
body mass index
insulin dose
multitrajectory group-based modeling
puberty
type 1 diabetes
Journal
The Journal of pediatrics
ISSN: 1097-6833
Titre abrégé: J Pediatr
Pays: United States
ID NLM: 0375410
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
08
07
2019
revised:
06
11
2019
accepted:
07
11
2019
pubmed:
19
1
2020
medline:
19
8
2020
entrez:
19
1
2020
Statut:
ppublish
Résumé
To analyze the interrelationship of metabolic control, age- and sex-adjusted body mass index, and daily insulin dose and to identify heterogeneous multivariate developmental curves from childhood to young adulthood in a large cohort of children with type 1 diabetes (T1D) STUDY DESIGN: Data were extracted from the diabetes follow-up registry DPV. Longitudinal data from 9239 participants with T1D age 8-18 years with diabetes duration ≥2 years and ≥5 years of follow-up were analyzed. We applied group-based multitrajectory modeling to identify latent groups of subjects following similar developmental curves across outcomes (hemoglobin A1c [HbA1c], age/sex-standardized body mass index [BMI-SDS], daily insulin dose per kg). Group number was based on Bayes information criterion and group size (≥5%). The group-based multitrajectory approach revealed 5 heterogeneous 3-variate trajectories during puberty. Individuals with stable good metabolic control, high-normal increasing BMI-SDS, and rising insulin dose patterns were classified as group 1 (33%). Group 2 (20%) comprised youths with intermediate-increasing HbA1c, low BMI-SDS, and steeply increasing insulin dose trajectories. Group 3 (11%) followed intermediate-rising HbA1c and high-normal increasing BMI-SDS developmental curves, while insulin dose increased steeply. In group 4 (14%), both high-increasing HbA1c and insulin dose trajectories were observed, while BMI-SDS was stable-normal. Group 5 (22%) included subjects with intermediate-rising HbA1c patterns, high-increasing BMI-SDS, and increasing insulin dose patterns. This study identified 5 distinct 3-variate curves of HbA1c, BMI-SDS, and insulin dose during puberty among youths with T1D. This approach demonstrates a considerable heterogeneity highlighting the importance of personalized medical care.
Identifiants
pubmed: 31952845
pii: S0022-3476(19)31520-3
doi: 10.1016/j.jpeds.2019.11.012
pii:
doi:
Substances chimiques
Blood Glucose
0
Glycated Hemoglobin A
0
Hypoglycemic Agents
0
Insulin
0
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
64-71.e3Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.