1 Department of Clinical Medicine - Department of Paediatrics, Department of Clinical Medicine, Health, Aarhus University2 Department of Clinical Medicine, Health, Aarhus University3 Health, Aarhus University4 The Department of Paediatrics, Faculty of Health Sciences, Aarhus University, Aarhus University5 Studienævnene på HE - Board of Studies, Health Science, Studienævnene på HE, Health, Aarhus University6 unknown7 Department of Clinical Medicine - Department of Paediatrics, Department of Clinical Medicine, Health, Aarhus University8 Studienævnene på HE - Board of Studies, Health Science, Studienævnene på HE, Health, Aarhus University9 Department of Clinical Medicine, Health, Aarhus University10 Health, Aarhus University
OBJECTIVETo determine the prevalence of residual -cell function (RBF) in children after 3-6 years of type 1 diabetes, and to examine the association between RBF and incidence of severe hypoglycemia, glycemic control, and insulin requirements.RESEARCH DESIGN AND METHODSA total of 342 children (173 boys) 4.8-18.9 years of age with type 1 diabetes for 3-6 years were included. RBF was assessed by testing meal-stimulated C-peptide concentrations. Information regarding severe hypoglycemia within the past year, current HbA(1c), and daily insulin requirements was retrieved from the medical records and through patient interviews.RESULTSNinety-two children (27%) had RBF >0.04 nmol/L. Patients with RBF 0.04 nmol/L (odds ratio, 2.59; 95% CI, 1.10-7.08; P <0.03). HbA(1c) was significantly higher in patients with RBF 0.04 nmol/L (mean, 8.49 0.08% [69.3 +/- 0.9 mmol/mol] vs. 7.92 +/- 0.13% [63.1 +/- 1.4 mmol/mol]; P <0.01), and insulin requirements were significantly lower in patients with RBF >0.2 nmol/L (mean +/- SE: 1.07 +/- 0.02 vs. 0.93 +/- 0.07 units/kg/day; P <0.04).CONCLUSIONSWe demonstrated considerable phenotypic diversity in RBF among children after 3-6 years of type 1 diabetes. Children with RBF are at lower risk for severe hypoglycemia, have better diabetes regulation, and have lower insulin requirements compared with children without RBF. There appears to be a lower limit for stimulated RBF of approximate to 0.04 nmol/L that confers a beneficial effect on hypoglycemia and metabolic control.
Diabetes Care, 2013, Vol 36, Issue 11, p. 3454-3459
MEAL TOLERANCE-TEST C-PEPTIDE CLINICAL-MANIFESTATIONS METABOLIC CONTROL GLYCEMIC CONTROL RISING INCIDENCE NATURAL-HISTORY MELLITUS AUTOANTIBODIES REMISSION