Identification and Follow-up of At-Risk Children Mitigate Disease Severity and Improve Treatment Outcomes in Type 1 Diabetes

OBJECTIVE: Interest in screening for type 1 diabetes (T1D) is increasing, but studies assessing outcomes during the treatment period among individuals identified through population-based genetic screening and prospective follow-up remain limited. RESEARCH DESIGN AND METHODS: Characteristics at T1D diagnosis and 1-year treatment outcomes were compared between 126 at-risk children followed in the Type 1 Diabetes Prediction and Prevention (DIPP) study and 440 children diagnosed outside the screening program. RESULTS: DIPP participants had significantly less frequent (P < 0.05) ketoacidosis (5.6% vs. 23.6%), dehydration, electrolyte imbalances, and need for intensive care, and shorter inpatient stays, than non-DIPP children. They showed lower median HbA1c levels (46 vs. 99 mmol/mol [6.4 vs. 11.2%]) and insulin requirements (0.11 vs. 0.74 units/kg/day) both at diagnosis and 1 year later (55 vs. 61 mmol/mol [7.2 vs. 7.7%]; 0.57 vs. 0.70 units/kg/day). CONCLUSIONS: DIPP participants had a milder clinical presentation at T1D diagnosis, with lower HbA1c levels and lower insulin requirements during the first year.