Factors predicting residual beta-cell function in the first year after diagnosis of childhood type 1 diabetes

Diabetes Res Clin Pract. 1991 Jan;11(1):9-16. doi: 10.1016/0168-8227(91)90135-z.

Abstract

Twenty-five children aged 2-14 years (mean age 8.39 +/- 0.78 years) were studied prospectively during the first year after the diagnosis of type 1 diabetes. Of their clinical and metabolic features at diagnosis, only age showed a significant independent relationship with endogenous C-peptide production during the first year. Age was correlated with higher values for basal and stimulated plasma C-peptide at 7-14 days after diagnosis, at 6 months and at 12 months. At diagnosis, age was also associated with a higher value for HbA1c and a lower prevalence of insulin antibodies. C-peptide production peaked at 3 months and thereafter declined. Mean HbA1c and insulin requirement were both minimal at 6 months. At diagnosis, there were significant inverse relationships between basal C-peptide production and both insulin dose and HbA1c and between stimulated C-peptide production and HbA1c. Basal and stimulated C-peptide production were inversely related to insulin dose at 6 and 12 months. Stimulated C-peptide was higher at 12 months in children retaining islet cell antibodies. These findings confirm the importance of age as a predictor of residual beta-cell function in type 1 diabetes and indicate that older children present clinically following a slower course of beta cell destruction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Autoantibodies / analysis
  • C-Peptide / blood*
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Infant
  • Insulin / therapeutic use*
  • Insulin Antibodies / analysis
  • Islets of Langerhans / immunology
  • Islets of Langerhans / metabolism*
  • Longitudinal Studies
  • Male
  • Prospective Studies

Substances

  • Autoantibodies
  • C-Peptide
  • Glycated Hemoglobin A
  • Insulin
  • Insulin Antibodies
  • islet cell antibody