JUVENILE IDIOPATHIC ARTHRITIS IN CHILDREN WITH TYPE 1 DIABETES: IMPACT OF CURRENT MEDICAL TREATMENT OPTIONS ON ANTHROPOMETRY AND METABOLIC CONTROL

Introduction: Treatment for juvenile idiopathic arthritis (JIA) has evolved, with less steroid use and increased reliance on biologic drugs. We hypothesize that these advances have reduced the impact on anthropometry and metabolic control in children with type 1 diabetes (T1D) and JIA.

Objectives: Our study examines the characteristics of children with T1D and JIA compared to a survey from 1995 to 2013 ([1]).

Methods: We evaluated data from patients with T1D, aged 0.5 to 18 years at diagnosis, and examinations documented between January 2014 and December 2023 at 387 DPV centers in Germany, Austria, Switzerland, and Luxembourg. JIA diagnoses were identified through documented diagnoses, ICD-10 codes and a list of trade names and active substances, including steroids and biologics. Statistical analyses compared JIA and non-JIA patients (χ²-test, Wilcoxon-test) for demographic and treatment parameters. Treatment and outcomes were compared between two 5-year periods (2014-2018, 2019-2023), and regression models evaluated outcome differences between JIA and non-JIA patients, adjusted for age, sex, migration background, and diabetes duration.

Results: Height and body mass index (BMI) were similar in 489 children with JIA and T1D compared to 67,462 children with T1D only (height-SDS 0.01 vs. 0.13; p=0.518) (BMI-SDS 0.18 vs. 0.30; p=0.086). Children with JIA and T1D showed comparable levels of activity in sports (weekly sports activities 2.7 h vs. 3.0 h; p=0.647). They more frequently utilized diabetes technologies, such as insulin pumps (70.0% vs. 58.1%; p<0.001), glucose sensors (80.0% vs. 73.6%; p=0.022) and automated insulin dosing systems (27.7% vs. 21.0%; p=0.004). Insulin doses (0.90 IE/kg/d vs. 0.87; p=0.157) and metabolic control (HbA1c 7.9% vs. 7.9%; p=1.0) were similar in both groups. The prevalence of hypertension (33.0% vs. 29.2%: p=0.518) was comparable; while the prevalence of dyslipidemia was significantly higher in children with T1D and JIA (42.1% vs. 32.7%; p<0.001). These children were more frequently treated with antihypertensive medication (8.0% vs. 2.7%; p<0.001), but not with statins (2.3% vs. 1.0%; p=0.082). Comparing treatment and outcomes between periods 2014-2018 and 2019-2023, BMI (BMI-SDS: 0.08 vs. 0.20, p=0.169) and height (Height-SDS: -0.12 vs. 0.06, p=0.083) remained similar among children with T1D and JIA. Insulin doses showed no significant differences (0.95 IE/kg/d vs. 0.89; p=0.146), while metabolic control improved over time (HbA1c 8.3% vs. 7.7%; p<0.001). Weekly sports activities remained constant over time (2.8 h vs. 2.7 h).

Conclusion: Children with T1D and JIA more frequently use modern diabetes technologies and achieve similar metabolic control compared to those with T1D alone. Their height and BMI remained stable over time, while HbA1c values improved. These data confirm good diabetes outcomes in children with T1D and JIA under current treatment options.

Publication History

Article published online:
28 May 2025

• Literatur

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