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1. Insulin dose-adjusted hemoglobin A1c (IDAA1c) ≤9 is commonly used to define partial remission in pediatric type 1 diabetes but has not been validated for U.S. youth.
2. The SEARCH for Diabetes in Youth study revealed that IDAA1c ≤9 underestimates β-cell function, particularly in youth with overweight or obesity.
3. Higher BMI increases insulin resistance and insulin requirements, reducing IDAA1c’s sensitivity to detect partial remission.
4. Adjusting IDAA1c cutoffs for BMI categories improved sensitivity but reduced specificity in identifying partial remission.
