AIMS/HYPOTHESIS: We studied the decline of C-peptide during the first year after diagnosis of Type 1 diabetes (T1D), and its relation to various factors. METHODS: 3824/4017 newly diagnosed patients (95%) were classified as T1D in a national study. In a non-selected subgroup of 1669 T1D patients we determined non-fasting C-peptide both at diagnosis and after 1 year, and analyzed decline in relation to clinical symptoms and signs, initial C-peptide and occurrence of auto-antibodies. RESULTS: Younger children lost more C-peptide (p<0.001) and the higher the C-peptide at diagnosis the larger the decline during the first year (p<0.0000). Patients with higher BMI had higher C-peptide at diagnosis but lost more (p<0.01), and those with lower HbA1c, without symptoms and signs at diagnosis, and with higher BMI, had higher C-peptide at diagnosis, but lost more during the first year (p<0.001). Finally, patients diagnosed during autumn had higher C-peptide at diagnosis, but lost more during the coming year (p<0.001). Occurrence of auto-antibodies did not correlate with C-peptide decline, except possibly for a more rapid loss in IAA-positive patients. CONCLUSIONS/ INTERPRETATION: Even in a restricted geographical area and narrow age range (<18 years), the natural course of Type 1 diabetes is heterogeneous. This should be considered in clinical trials.
AIMS/HYPOTHESIS: We studied the decline of C-peptide during the first year after diagnosis of Type 1 diabetes (T1D), and its relation to various factors. METHODS: 3824/4017 newly diagnosed patients (95%) were classified as T1D in a national study. In a non-selected subgroup of 1669 T1D patients we determined non-fasting C-peptide both at diagnosis and after 1 year, and analyzed decline in relation to clinical symptoms and signs, initial C-peptide and occurrence of auto-antibodies. RESULTS: Younger children lost more C-peptide (p<0.001) and the higher the C-peptide at diagnosis the larger the decline during the first year (p<0.0000). Patients with higher BMI had higher C-peptide at diagnosis but lost more (p<0.01), and those with lower HbA1c, without symptoms and signs at diagnosis, and with higher BMI, had higher C-peptide at diagnosis, but lost more during the first year (p<0.001). Finally, patients diagnosed during autumn had higher C-peptide at diagnosis, but lost more during the coming year (p<0.001). Occurrence of auto-antibodies did not correlate with C-peptide decline, except possibly for a more rapid loss in IAA-positive patients. CONCLUSIONS/ INTERPRETATION: Even in a restricted geographical area and narrow age range (<18 years), the natural course of Type 1 diabetes is heterogeneous. This should be considered in clinical trials.
Authors: Linda A DiMeglio; Peiyao Cheng; Roy W Beck; Craig Kollman; Katrina J Ruedy; Robert Slover; Tandy Aye; Stuart A Weinzimer; Andrew A Bremer; Bruce Buckingham Journal: Pediatr Diabetes Date: 2015-02-27 Impact factor: 4.866
Authors: W M Kuhtreiber; S L L Washer; E Hsu; M Zhao; P Reinhold; D Burger; H Zheng; D L Faustman Journal: Diabet Med Date: 2015-08-16 Impact factor: 4.359
Authors: Vit Neuman; Ondrej Cinek; David P Funda; Tomas Hudcovic; Jaroslav Golias; Lenka Kramna; Lenka Petruzelkova; Stepanka Pruhova; Zdenek Sumnik Journal: Diabetologia Date: 2019-04-25 Impact factor: 10.122
Authors: Anna Neyman; Jennifer Nelson; Sarah A Tersey; Raghavendra G Mirmira; Carmella Evans-Molina; Emily K Sims Journal: Diabetes Obes Metab Date: 2018-08-24 Impact factor: 6.577
Authors: Cate Speake; Samuel O Skinner; Dror Berel; Elizabeth Whalen; Matthew J Dufort; William Chad Young; Jared M Odegard; Anne M Pesenacker; Frans K Gorus; Eddie A James; Megan K Levings; Peter S Linsley; Eitan M Akirav; Alberto Pugliese; Martin J Hessner; Gerald T Nepom; Raphael Gottardo; S Alice Long Journal: JCI Insight Date: 2019-12-05