Preservation of beta-cell function in autoantibody-positive youth with diabetes.
OBJECTIVE
To determine the extent of beta-cell function in youth with diabetes and GAD65 and/or IA2 autoantibodies.


METHODS
Fasting C-peptide levels from 2,789 GAD65- and/or IA2 autoantibody-positive youth aged 1-23 years from the SEARCH for Diabetes in Youth study were used. Preserved beta-cell function was defined on the basis of cut points derived from the Diabetes Control and Complications Trial (DCCT) (fasting C-peptide > or =0.23 ng/ml) and from the U.S. adolescent population of the National Health and Nutrition Examination Survey (NHANES) 5th percentile for fasting C-peptide (> or =1.0 ng/ml). We compared the clinical characteristics between those with and without preserved beta-cell function.


RESULTS
Within the first year of diagnosis, 82.9% of youth had a fasting C-peptide > or =0.23 ng/ml and 31.2% had values > or =1.0 ng/ml. Among those with > or =5 years of diabetes duration, 10.7% had preserved beta-cell function based on the DCCT cutoff and 1.0% were above the 5th percentile of the NHANES population.


CONCLUSIONS
Within the 1st year of diagnosis, four of five youth with autoantibody-positive diabetes have clinically significant amounts of residual beta-cell function and about one-third have fasting C-peptide levels above the 5th percentile of a healthy adolescent population. Even 5 years after diagnosis, 1 of 10 has fasting C-peptide above a clinically significant threshold. These findings have implications for clinical classification of youth with diabetes as well as clinical trials aimed to preserve beta-cell function after diabetes onset.
Greenbaum
Carla J
CJ
Diabetes Research Program, Benaroya Research Institute, Seattle,Washington, USA. cjgreen@benaroyaresearch.org
Anderson
Andrea M
AM
Dolan
Lawrence M
LM
Mayer-Davis
Elizabeth J
EJ
Dabelea
Dana
D
Imperatore
Giuseppina
G
Marcovina
Santica
S
Pihoker
Catherine
C
D000293:Adolescent; D001323:Autoantibodies / Q000276:immunology*; D002096:C-Peptide / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000276:immunology* / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D050417:Insulin-Secreting Cells / Q000378:metabolism / Q000473:pathology*; D008297:Male; D055815:Young Adult
D001323:Autoantibodies; D002096:C-Peptide