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Changes in beta cell function during the proximate post‐diagnosis period in persons with type 1 diabetes
Author(s) -
DiMeglio Linda A,
Cheng Peiyao,
Beck Roy W,
Kollman Craig,
Ruedy Katrina J,
Slover Robert,
Aye Tandy,
Weinzimer Stuart A,
Bremer Andrew A,
Buckingham Bruce
Publication year - 2016
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12271
Subject(s) - medicine , c peptide , diabetes mellitus , peptide , type 1 diabetes , endocrinology , biochemistry , biology
Objective Prior studies examining beta‐cell preservation in type 1 diabetes have predominantly assessed stimulated C‐peptide concentrations approximately 10 wk after diagnosis. We examined whether earlier assessments might aid in prediction of beta cell function over time. Methods Using data from a multi‐center randomized trial assessing the effect of intensive diabetes management initiated within 1 wk of diagnosis, we assessed which clinical factors predicted 90‐min mixed‐meal tolerance test ( MMTT ) stimulated C‐peptide values obtained 2 and 6 wk after diagnosis. We also studied associations of these factors with C‐peptide values at 1‐ and 2‐year post‐diagnosis. Data from intervention and control groups were pooled. Results Among 67 study participants (mean age 13.3 ± 5.7 yr, range 7.8–45.7 yr) in multivariable analyses, C‐peptide increased from baseline to 2 wks and then 6 wk. C‐peptide levels at these times were significantly correlated with 1‐ and 2‐yr C‐peptide concentrations (all p < 0.001), with the strongest observed associations between 6‐wk C‐peptide and the 1‐ and 2‐yr values (r = 0.66 and r = 0.61, respectively). In multivariable analyses, greater baseline and 6‐wk C‐peptide, and older age independently predicted greater 1‐ and 2‐yr C‐peptide concentrations. Conclusions C‐peptide assessments close to diagnosis were predictive of subsequent C‐peptide production. Our data demonstrate a clear increase in C‐peptide over the initial 6 wk after diabetes diagnosis followed by a plateau. Our data do not suggest that MMTT assessments performed closer to diagnosis than 6 wk would improve prediction of subsequent residual beta cell function.