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Early and late C‐peptide responses during oral glucose tolerance testing are oppositely predictive of type 1 diabetes in autoantibody‐positive individuals
Author(s) -
Ismail Heba M.,
Becker Dorothy J.,
Libman Ingrid,
Herold Kevan C.,
Redondo Maria J.,
Atkinson Mark A.,
Cleves Mario A.,
Palmer Jerry,
Sosenko Jay
Publication year - 2020
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13982
Subject(s) - type 1 diabetes , medicine , c peptide , autoantibody , diabetes mellitus , receiver operating characteristic , endocrinology , area under the curve , body mass index , immunology , antibody
We examined whether the timing of the C‐peptide response during an oral glucose tolerance test (OGTT) in relatives of patients with type 1 diabetes (T1D) is predictive of disease onset. We examined baseline 2‐h OGTTs from 670 relatives participating in the Diabetes Prevention Trial‐Type 1 (age: 13.8 ± 9.6 years; body mass index z‐score: 0.3 ± 1.1; 56% male) using univariate regression models. T1D risk increased with lower early C‐peptide responses (30–0 min) (χ 2 = 28.8, P < 0.001), and higher late C‐peptide responses (120–60 min) (χ 2 = 23.3, P < 0.001). When both responses were included in a proportional hazards model, they remained independently and oppositely associated with T1D, with a stronger overall association for the combined model than either response alone (χ 2 = 41.1; P < 0.001). Using receiver operating characteristic curve analysis, the combined early and late C‐peptide response was more accurately predictive of T1D than area under the curve C‐peptide ( P = 0.005). Our findings demonstrate that lower early and higher late C‐peptide responses serve as indicators of increased T1D risk.