Changes in beta cell function during the proximate post-diagnosis period in persons with type 1 diabetes

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

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)237-243
Number of pages7
JournalPediatric Diabetes
Volume17
Issue number4
DOIs
StatePublished - Jun 1 2016

Keywords

  • Clinical science
  • Diabetes in childhood
  • Insulin secretions in vivo

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism

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    Dimeglio, L. A., Cheng, P., Beck, R. W., Kollman, C., Ruedy, K. J., Slover, R., Aye, T., Weinzimer, S. A., Bremer, A. A., & Buckingham, B. (2016). Changes in beta cell function during the proximate post-diagnosis period in persons with type 1 diabetes. Pediatric Diabetes, 17(4), 237-243. https://doi.org/10.1111/pedi.12271