1365-P: Metabolic Control Three Years after Diagnosis in Children with T1D: Is DKA at Onset or HbA1c at Onset Closer Associated with Third Year HbA1c? Data from the International Pediatric Diabetes Registry SWEET
Bibliographic record
Abstract
Objective: To establish if DKA at onset or HbA1c at onset is closer associated with metabolic control three years after diagnosis in a large, heterogeneous, international T1D cohort. Methods: Data were collected from the international diabetes registry SWEET. 1420 T1D children (54% boys; 994 from Northern Europe, 341 from Southern Europe, 85 from America/Canada), diagnosed before 18 years, with documented clinical presentation and HbA1c at onset and follow-up data available were included. Patients were grouped according to presentation at onset: DKA with coma, DKA without coma and no DKA; and HbA1c at onset: low (HbA1c <10%), medium (10-<12%) and high (≥12%). To adjust for age at onset, gender and region, linear regression models were applied (adjusted means with 95% CI). Vuong test was employed to compare the association between third year HbA1c and both HbA1c at onset and presentation at onset. Results: Median age at T1D onset was 9.1 [Q1; Q3: 5.8; 12.2] years. DKA with coma was present in 6% of children, DKA without coma in 37% and no DKA in 57%. No significant differences were found in third year HbA1c between DKA with coma 7.7 (7.4;8.0)%, DKA without coma 7.5 (7.4;7.6)% and no DKA group 7.6 (7.5;7.7)% [adjusted means (95% CI)]. Third year HbA1c was lower (7.4 (7.3;7.5)%) in low HbA1c compared to high HbA1c at onset group (7.7 (7.6;7.8)%, p<0.01). In the medium HbA1c group, third year HbA1c was 7.5 (7.4;7.6)% (no differences). Comparing the model with HbA1c at onset groups vs. the model with presentation at onset groups, the model with HbA1c at onset was closer associated with the third year HbA1c (p=0.02). Conclusions The high percentage of DKA at T1D onset is still a concern worldwide. The level of HbA1c at onset was more closely associated with long term T1D control than the DKA at onset. Early T1D diagnosis, preventing high HbA1c at onset as well as DKA at onset, is important for long term metabolic control. Disclosure B. Piccini: None. A. Schwandt: None. I. Arslanoglu: None. R. Cardona-Hernandez: None. R. Coutant: None. C.A. Jefferies: None. J. Kim: None. O. Kordonouri: None. C. Limbert: None. R. Preiksa: None. A. Pundziute Lyckå: None. B. Rami-Merhar: Speaker's Bureau; Self; Eli Lilly and Company, Medtronic, Menarini Group, Roche Diabetes Care. E. Richmond: None. R. Savova: None. S. Todorovic: None. H.J. Veeze: Consultant; Self; Medtronic MiniMed, Inc. S. Toni: None.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".