2256-P: Modifiable Predictors of Long-Term Durability of Partial Clinical Remission in Adults with Newly Diagnosed Type 1 Diabetes (InLipoDiab1 Study)

Introduction and Objective: Partial clinical remission (pCR) of type 1 diabetes (T1D) is associated with improved metabolic stability and favorable long-term outcomes. In adult-onset T1D, pCR may persist for several years, yet determinants of sustained pCR remain poorly defined, particularly across different pCR definitions. Methods: We analyzed 265 adults with newly diagnosed T1D (32% women) enrolled to InLipoDiab1 Study (NCT02306005). Median follow-up was 4.29 (1.25-7.15) years. pCR was defined using five criteria: stimulated C-peptide>300 pmol/L; Diabetes Poland (C-peptide>0.5 ng/mL, HbA1c≤7%, insulin dose (DDI)<0.3 IU/kg/day); ISPAD (DDI <0.5 IU/kg/day, HbA1c<7%); Mortensen (IDAA1c≤9); and Schoelin (DDI ≤ 0.3 IU/kg/day, HbA1c≤6.4%) definitions. pCR duration was defined from diagnosis to the last visit at which pCR was confirmed. Ordinal logistic regression was used to model pCR duration categories (none to ≥5 years). Models were fitted for each pCR criterion. Baseline demographic and metabolic covariates were evaluated in primary models, with additional criterion-specific models examining 3-month post-diagnosis HbA1c and DDI. Results: The proportion of pCR varied by definition (39%-78%). Median pCR duration was 1.02 (0.36-2.03) yrs (up to 9.05 yrs). Across pCR definitions, current smoking at diagnosis was consistently associated with lower (51-70%) and higher BMI with higher (9-15%) odds of longer pCR duration (all p<0.05). Higher HbA1c and DDI at 3 months post-diagnosis were associated with reduced (56%-89%, 4.2-7.5%) pCR durability odds (all p<0.01, p<05, respectively). Kaplan-Meier plots showed marked heterogeneity in pCR persistence. Mortensen criterion was identifying the longest remission. Conclusion: pCR duration in adult-onset T1D varies strongly on the definition used. Smoking at diagnosis and suboptimal early glycemic control are robust, modifiable predictors of shorter pCR, supporting early intervention, screening programs and the need for standardized pCR definitions. Disclosure A.A. Uruska: Other - lecturer; Ended; Novo Nordisk, Lilly Diabetes, Boehringer Ingelheim International GmbH, AstraZeneca. A.S. Januszewski: None. A. Grzelka-Wozniak: Other - Speaker; Ended; Novo Nordisk, Eli Lilly and Company, AstraZeneca, Roche Diabetes Care, Boehringer Ingelheim International GmbH. A. Zawiejska: None. M. Mietkiewska-Dolecka: None. A. Duda-Sobczak: None. J. Flotynska: None. M. Serwinski: None. M. Kulecki: None. D. Zozulinska-Ziólkiewicz: Advisory Panel; Current; Abbott Diabetes. Speaker's Bureau; Current; Abbott Diabetes, Eli Lilly and Company, Novo Nordisk, Sanofi, Dexcom, Inc. Advisory Panel; Current; Medtronic. Speaker's Bureau; Current; Medtronic, Servier Laboratories.