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BackgroundType 1 diabetes in young children is a heavy parental burden. As part of pilot phase of the KIDSAP01 study, we conducted a baseline assessment in parents to study the association between hypoglycemia fear, parental well-being and child behavior.MethodsAll parents were invited to fill in baseline questionnaires: hypoglycemia fear survey (HFS), WHO-5, Epworth Sleepiness Scale and Strength and Difficulties Questionnaire (SDQ).Results24 children (median age: 5-year, range 1-7 years, 63% male, mean diabetes duration: 3 ± 1.7 years) participated. 23/24 parents filled out the questionnaires. We found a higher score for the hypoglycemia fear behavior 33.9 ± 5.6 compared to hypoglycemia worry 34.6 ± 12.2. Median WHO-5 score was 16 (8 - 22) with poor well-being in two parents. Median daytime sleepiness score was high in five parents (>10). For six children a high total behavioral difficulty score (>16) was reported. Pro social behavior score was lower than normal in six children (r = - 0.50, p r = - 0.44, p r = - 0.45, p = .05) and positively with child age and diabetes duration (r = 0.58, p r = 0.6, p ConclusionRegular screening of parental well-being, hypoglycemia fear and child behavior should be part of routine care to target early intervention.

Worsening metabolic control, weight changes and increasing insulin dose during puberty have emerged as a challenge in diabetes care. However, individual variation is large. Data from the German/Austrian/Luxembourgian diabetes registry DPV were used to identify distinct patterns of hemoglobin A1c (HbA1c), age/sex-standardized body mass index (BMI-SDS) and daily insulin dose from childhood to young adulthood. Longitudinal data from 9,239 participants with T1D aged 8 to 18 years with duration >=2 years and >=5 years of follow-up were analyzed. We applied group-based multitrajectory (GBMT) modeling, a generalization of the group-based trajectory approach, to identify latent groups of subjects following similar developmental curves over time across multiple variables (Nagin, 2018). The GBMT approach revealed five unique groups of heterogeneous HbA1c, BMI-SDS and insulin dose patterns over time (Fig1). Differences in age at onset, gender, migration background as well as height-SDS, insulin pump and CGM usage, frequency of SMBG and physical activity were found across all groups. The present study identified for the first time five distinct multitrajectories of HbA1c, BMI-SDS and insulin dose during puberty. This approach demonstrates that variability between individuals is obscured by statistics on central tendency. Disclosure A. Schwandt: None. O. Kuss: None. D.P. Dunstheimer: None. B. Karges: None. T.M. Kapellen: None. T. Meissner: None. M. Witsch: None. M. Flury: Other Relationship; Self; Pfizer Inc. S. Straubinger: None. R.W. Holl: None. Funding German Center for Diabetes Research; Robert Koch Institute; German Diabetes Association

Type 1 diabetes (T1D) is associated with additional autoimmune and endocrine disorders; however, their prevalences internationally are poorly understood. We analyzed 22,632 patients from the U.S. T1D Exchange (T1DX) registry (median age 18 years) and 38,470 patients from the German/Austrian DPV registry (median age 16 years) with T1D duration ≥1 year (median duration 10 and 6 years, respectively) with data between 01/2016 and 03/2018. Reported prevalences of thyroid disease, arthritis, Addison’s disease, and atrophic gastritis were compared using logistic regression models with registry, age group, and sex as covariates. Thyroid disease was more frequent in the T1DX, whereas arthritis was more frequent in the DPV. Prevalence increased with age in both registries. We found no significant differences between T1DX and DPV for Addison’s disease (Figure). Atrophic gastritis was rare in both registries (T1DX: n=3, DPV: n=21). After adjustment for age, thyroid disease was about twice as frequent in females compared with males (T1DX: 25 vs. 13%, DPV: 15 vs. 7%, both p Disclosure J. Hermann: None. K. Miller: None. G. Szinnai: None. N.C. Foster: None. T.M. Kapellen: None. L. DiMeglio: Research Support; Self; Amgen Inc., Caladrius Biosciences, Inc., Janssen Research & Development, Medtronic, Sanofi. Other Relationship; Self; Dexcom, Inc. E. Fröhlich-Reiterer: None. J.B. McGill: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Gilead Sciences, Inc., Novo Nordisk Inc., Sanofi US. Research Support; Self; Dexcom, Inc., Medtronic, Novartis AG, Sanofi US. Speaker's Bureau; Self; Aegerion Pharmaceuticals, Dexcom, Inc., Janssen Pharmaceuticals, Inc., MannKind Corporation. R.W. Holl: None. D.M. Maahs: Advisory Panel; Self; Novo Nordisk Inc. Consultant; Self; Abbott, Sanofi. Research Support; Self; Dexcom, Inc., Tandem Diabetes Care. Funding German Center for Diabetes Research; The Leona M. and Harry B. Helmsley Charitable Trust; German Center for Diabetes Research; German Diabetes Association; European Foundation for the Study of Diabetes; INNODIA

Zum Screening auf einen fruhen Typ-2-Diabetes wird bei Kindern und Jugendlichen der orale Glukosetoleranztest empfohlen. Eine grose Studie zeigt, dass sich der HbA1c-Wert besser eignet.