P-488: Evaluating insulin dose-adjusted HbA1c (IDAA1c) for early detection of the honeymoon phase in newly diagnosed type 1 diabetes: an Indian experience
S Shamkiran, N K Bhat, N Upadhya PYAbstract
Introduction
The Insulin dose-adjusted HbA1c (IDAA1c) is a validated marker for identifying the honeymoon phase in type 1 diabetes. However, no Indian studies to date have assessed its feasibility or clinical utility
Objectives
This study aimed to evaluate the feasibility and usefulness of early IDAA1c monitoring and to explore predictors of remission
Methods
This retrospective study included 15 children diagnosed with type 1 diabetes between January 2024 and June 2025 at a pediatric endocrine clinic. Clinical details including age at diagnosis, insulin doses, HbA1c at 3, 6, and 12 months were obtained from medical records. IDAA1c was calculated at 3 and 6 months using the formula: HbA1c (%) + [4 × total daily insulin dose (U/kg/day)]. Partial remission was defined as IDAA1c ≤9. Patients were classified as remitters or non-remitters based on 3-month IDAA1c. Group comparisons and correlations were analyzed using appropriate statistical tests
Results
The median age of the cohort was 7.3 years (IQR 5.3–8.1). IDAA1c could be calculated in all children, confirming feasibility. At 3 months, 8 (53%) patients met criteria for partial remission. These remitters had significantly lower insulin requirements at 6 months compared to non-remitters (median 0.58 vs 1.1 U/kg/day; p = 0.0026). IDAA1c at 3 months showed strong positive correlation with HbA1c at 6 months (rs = 0.86, p = 0.003). Among six patients with 12-month follow-up, three maintained IDAA1c ≤9, indicating sustained remission. Median age was higher in remitters (7.3 vs 6.9 years), but not statistically significant (p = 0.7). No significant association was found between DKA at presentation and remission status (p = 0.57).
Conclusions
Early IDAA1c monitoring is feasible and useful in predicting glycemic outcomes. While age and DKA were not significant predictors, IDAA1c at 3 months strongly correlated with future glycemic control.