Factors predicting residual beta-cell function in the first year after diagnosis of childhood type 1 diabetes.
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.
Couper
J J
JJ
Department of Endocrinology and Diabetes, Royal Children's Hospital, Parkville, Victoria, Australia.
Hudson
I
I
Werther
G A
GA
Warne
G L
GL
Court
J M
JM
Harrison
L C
LC
D000293:Adolescent; D000367:Age Factors; D001323:Autoantibodies / Q000032:analysis; D002096:C-Peptide / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007223:Infant; D007328:Insulin / Q000627:therapeutic use*; D007330:Insulin Antibodies / Q000032:analysis; D007515:Islets of Langerhans / Q000276:immunology / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies
D001323:Autoantibodies; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin; D007330:Insulin Antibodies; C024211:islet cell antibody