Fall in C-Peptide During First 4 Years From Diagnosis of Type 1 Diabetes : Variable Relation to Age, HbA1c, and Insulin Dose
© 2016 by the American Diabetes Association..
OBJECTIVE: We aimed to describe the natural history of residual insulin secretion in Type 1 Diabetes TrialNet participants over 4 years from diagnosis and relate this to previously reported alternative clinical measures reflecting β-cell secretory function.
RESEARCH DESIGN AND METHODS: Data from 407 subjects from 5 TrialNet intervention studies were analyzed. All subjects had baseline stimulated C-peptide values of ≥0.2 nmol/L from mixed-meal tolerance tests (MMTTs). During semiannual visits, C-peptide values from MMTTs, HbA1c, and insulin doses were obtained.
RESULTS: The percentage of individuals with stimulated C-peptide of ≥0.2 nmol/L or detectable C-peptide of ≥0.017 nmol/L continued to diminish over 4 years; this was markedly influenced by age. At 4 years, only 5% maintained their baseline C-peptide secretion. The expected inverse relationships between C-peptide and HbA1c or insulin doses varied over time and with age. Combined clinical variables, such as insulin-dose adjusted HbA1c (IDAA1C) and the relationship of IDAA1C to C-peptide, also were influenced by age and time from diagnosis. Models using these clinical measures did not fully predict C-peptide responses. IDAA1C ≤9 underestimated the number of individuals with stimulated C-peptide ≥0.2 nmol/L, especially in children.
CONCLUSIONS: Current trials of disease-modifying therapy for type 1 diabetes should continue to use C-peptide as a primary end point of β-cell secretory function. Longer duration of follow-up is likely to provide stronger evidence of the effect of disease-modifying therapy on preservation of β-cell function.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
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| Enthalten in: |
Diabetes care - 39(2016), 10 vom: 16. Okt., Seite 1664-70 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hao, Wei [VerfasserIn] |
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| Links: |
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| Themen: |
C-Peptide |
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| Anmerkungen: |
Date Completed 16.10.2017 Date Revised 07.12.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.2337/dc16-0360 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a Date Completed 16.10.2017 | ||
| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2016 by the American Diabetes Association. | ||
| 520 | |a OBJECTIVE: We aimed to describe the natural history of residual insulin secretion in Type 1 Diabetes TrialNet participants over 4 years from diagnosis and relate this to previously reported alternative clinical measures reflecting β-cell secretory function | ||
| 520 | |a RESEARCH DESIGN AND METHODS: Data from 407 subjects from 5 TrialNet intervention studies were analyzed. All subjects had baseline stimulated C-peptide values of ≥0.2 nmol/L from mixed-meal tolerance tests (MMTTs). During semiannual visits, C-peptide values from MMTTs, HbA1c, and insulin doses were obtained | ||
| 520 | |a RESULTS: The percentage of individuals with stimulated C-peptide of ≥0.2 nmol/L or detectable C-peptide of ≥0.017 nmol/L continued to diminish over 4 years; this was markedly influenced by age. At 4 years, only 5% maintained their baseline C-peptide secretion. The expected inverse relationships between C-peptide and HbA1c or insulin doses varied over time and with age. Combined clinical variables, such as insulin-dose adjusted HbA1c (IDAA1C) and the relationship of IDAA1C to C-peptide, also were influenced by age and time from diagnosis. Models using these clinical measures did not fully predict C-peptide responses. IDAA1C ≤9 underestimated the number of individuals with stimulated C-peptide ≥0.2 nmol/L, especially in children | ||
| 520 | |a CONCLUSIONS: Current trials of disease-modifying therapy for type 1 diabetes should continue to use C-peptide as a primary end point of β-cell secretory function. Longer duration of follow-up is likely to provide stronger evidence of the effect of disease-modifying therapy on preservation of β-cell function | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a C-Peptide |2 NLM | |
| 650 | 7 | |a Glycated Hemoglobin A |2 NLM | |
| 650 | 7 | |a Hypoglycemic Agents |2 NLM | |
| 650 | 7 | |a Insulin |2 NLM | |
| 700 | 1 | |a Gitelman, Steven |e verfasserin |4 aut | |
| 700 | 1 | |a DiMeglio, Linda A |e verfasserin |4 aut | |
| 700 | 1 | |a Boulware, David |e verfasserin |4 aut | |
| 700 | 1 | |a Greenbaum, Carla J |e verfasserin |4 aut | |
| 700 | 0 | |a Type 1 Diabetes TrialNet Study Group |e verfasserin |4 aut | |
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