Factors related to β-cell residual function in the diagnosis of type 1 diabetes mellitus

Authors

  • Vera Gonçalves Pediatric Endocrinology Unit, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António
  • Liliana Teixeira Pediatric Endocrinology Unit, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António https://orcid.org/0000-0001-5364-9397
  • Joana Freitas Pediatric Endocrinology Unit, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António https://orcid.org/0000-0001-5899-8385
  • Maria João Oliveira Pediatric Endocrinology Unit, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António
  • Teresa Borges Pediatric Endocrinology Unit, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v32.i1.26262

Keywords:

β-cell function, c-peptide, type 1 diabetes mellitus

Abstract

Objective: To identify factors associated with C-peptide levels at the diagnosis of type 1 diabetes mellitus (T1DM).
Material and Methods: Retrospective review of the clinical records of patients with newly diagnosed T1DM admitted to a Portuguese reference center between August 2010 and July 2019.
Results: The study included 109 subjects, with a mean age at T1DM diagnosis of 8.6 years and 29.4% already showing puberty development. The mean body mass index (BMI) z-score was 0.09. Subjects presented a median fasting C-peptide level of 0.46 ng/mL and a median hemoglobin A1C (HbA1C) of 10.85%. Diabetic ketoacidosis was identified in 22% of patients.
A positive correlation was found between fasting C-peptide levels and age at diagnosis (p<0.001) and between fasting C-peptide levels and BMI z-score (p=0.041). Higher C-peptide levels were found in overweight/obese (p=0.008) and pubertal (p<0.001) individuals. C-peptide levels were found to be correlated with serum bicarbonate (p=0.005) but not with venous pH, HbA1C, or previous symptom duration. No statistically significant differences were observed in fasting C-peptide levels according to gender, diabetes autoantibodies, T1DM family history, or seasonality.
Conclusion: Older, pubertal, and overweight/obese children presented higher C-peptide levels. In the acute setting, serum bicarbonate was the biochemical parameter that best correlated with residual β-cell function.

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References

Ehlers MR. Immune interventions to preserve beta cell function in type 1 diabetes. Journal of investigative medicine: the official publication of the American Federation for Clinical Research. 2016;64(1):7-13.

Couper JJ, Haller MJ, Greenbaum CJ, Ziegler AG, Wherrett DK, Knip M, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Stages of type 1 diabetes in children and adolescents. Pediatric diabetes. 2018;19 Suppl 27:20-7.

Keenan HA, Sun JK, Levine J, Doria A, Aiello LP, Eisenbarth G, et al. Residual insulin production and pancreatic ss-cell turnover after 50 years of diabetes: Joslin Medalist Study. Diabetes. 2010;59(11):2846-53.

Hwang JW, Kim MS, Lee DY. Factors Associated with C-peptide Levels after Diagnosis in Children with Type 1 Diabetes Mellitus. Chonnam medical journal. 2017;53(3):216-22.

Leighton E, Sainsbury CA, Jones GC. A Practical Review of C-Peptide Testing in Diabetes. Diabetes therapy : research, treatment and education of diabetes and related disorders. 2017;8(3):475-87.

Wolfsdorf JI, Glaser N, Agus M, Fritsch M, Hanas R, Rewers A, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatric diabetes. 2018;19 Suppl 27:155-77.

Szypowska A, Groele L, Wysocka-Mincewicz M, Mazur A, Lisowicz L, Ben-Skowronek I, et al. Factors associated with preservation of C-peptide levels at the diagnosis of type 1 diabetes. Journal of diabetes and its complications. 2018;32(6):570-4.

Yu HW, Lee YJ, Cho WI, Lee YA, Shin CH, Yang SW. Preserved C-peptide levels in overweight or obese compared with underweight children upon diagnosis of type 1 diabetes mellitus. Ann Pediatr Endocrinol Metab. 2015;20(2):92-7.

Leete P, Mallone R, Richardson SJ, Sosenko JM, Redondo MJ, Evans-Molina C. The Effect of Age on the Progression and Severity of Type 1 Diabetes: Potential Effects on Disease Mechanisms. Current diabetes reports. 2018;18(11):115.

VanBuecken DE, Greenbaum CJ. Residual C-peptide in type 1 diabetes: what do we really know? Pediatric diabetes. 2014;15(2):84-90.

Kim S, Park M. Effects of growth hormone on glucose metabolism and insulin resistance in human. Ann Pediatr Endocrinol Metab. 2017:145–52.

Liu J, Bian L, Ji L, Chen Y, Chen H, Gu Y, et al. The heterogeneity of islet autoantibodies and the progression of islet failure in type 1 diabetic patients. Science China Life sciences. 2016;59(9):930-9.

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Published

2023-06-23

How to Cite

1.
Gonçalves V, Teixeira L, Freitas J, Oliveira MJ, Borges T. Factors related to β-cell residual function in the diagnosis of type 1 diabetes mellitus. REVNEC [Internet]. 2023Jun.23 [cited 2024Feb.24];32(1):9-14. Available from: https://revistas.rcaap.pt/nascercrescer/article/view/26262

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