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. 2025 Mar-Apr;101(2):167-171.
doi: 10.1016/j.jped.2024.09.005. Epub 2024 Nov 4.

An analysis of the remission phase in type 1 diabetes within a multiethnic Brazilian sample

Maria E N Ramos  1 , Isabella S Leão  2 , Joana R D Vezzani  2 , Ludmila N R Campos  3 , Jorge L Luescher  3 , Renata S Berardo  4 , Lenita Zajdenverg  2 , Melanie Rodacki  2
Affiliations

An analysis of the remission phase in type 1 diabetes within a multiethnic Brazilian sample

Maria E N Ramos et al. J Pediatr (Rio J). 2025 Mar-Apr.

Abstract

Objective: To assess the frequency and potential influencing factors of the remission phase (RP) in Type 1 Diabetes (T1D) as well as the associations between various criteria used for its definition.

Methods: This was a retrospective cohort study based on data collected from medical records. Three criteria were used to evaluate RP: (1) Glycated hemoglobin (HbA1c) < 7.5 % with an insulin dose < 0.5 U/Kg/day, (2) HbA1c < 7 % with an insulin dose < 0.5 U/Kg/day, and (3) Insulin Dose Adjusted A1c (IDAA1c) ≤ 9, calculated as IDAA1c = HbA1c (%) + [4 x insulin dose (U/Kg/day)]. Statistical analyses included the Mann-Whitney U Test, Chi-Square Test, and Spearman Correlation.

Results: The sample consisted of 144 T1D patients, with a mean age of 26.22 ± 8.30 years and a mean age of onset of 13.30 ± 8.50 years. Of these, 52.9 % were female, 60.3 % were Caucasoid, and 31 % experienced diabetic ketoacidosis (DKA) at disease onset. One year after diagnosis, the occurrence of RP ranged from 27.2 % to 46.8 %, depending on the criteria used. Three patients experienced RP even after seven years, according to criterion 3. No association was found between RP and age, DKA, or pubertal status at onset. The three RP criteria were highly associated with each other (p < 0.001).

Conclusion: A significant proportion of patients in this sample experienced RP within 12 months of diagnosis. The three criteria for defining RP were strongly associated, indicating their reliability in both clinical and research contexts.

Keywords: Autoimmunity; Diabetes; Remission phase; Type 1 diabetes.

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Conflict of interest statement

Conflicts of interest The authors declare no conflicts of interest.

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