Influence of plasma glucagon levels on glycemic control in children with type 1 diabetes.
OBJECTIVE
The aim of this study was to investigate the association between plasma glucose (PG), HbA1c and plasma glucagons levels in children with type 1 diabetes to determine the influence of plasma glucagon on their glycemic control.


METHODS
The study was conducted in 60 Japanese children, aged 13.3 ± 4.6 years, with type 1 diabetes for at least 3 years of diabetes. Most of the subjects had absent pancreatic β-cell function. We compared the glucagon levels among patient groups stratified according to the 2-hour postprandial levels (<50, 50-99, 100-199, 200-299, and ≥ 300 mg/dL), and the HbA1c levels (<7.0, 7.0-7.9, 8.0-8.9, and ≥ 9%).


RESULTS
The mean 2-hour postprandial PG, HbA1c and plasma glucagon levels were 174 ± 97 mg/dL, 7.7 ± 1.3% and 84.0 ± 32.6 pg/mL, respectively. The glucagon levels were highly correlated with the PG levels (r=0.553, P<0.0001) and mildly correlated with the HbA1c levels (r=0.301, P=0.0192). Patients with high PG levels had significantly higher levels of glucagon as compared with those with lower PG levels (139.4 ± 47.2, 78.4 ± 17.3, 82.4 ± 21.0, 98.3 ± 29.2 and 93.8 ± 18.3 pg/mL, P=0.0009). On the other hand, there were no significant differences in plasma glucagon levels among patient groups stratified according to HbA1c levels (P=0.1566), however, patients with HbA1c levels ≥ 9% had significantly higher levels of glucagon than those with HbA1c levels < 7% (113.3 ± 53.4 vs 80.8 ± 18.4 pg/mL, P=0.0291).


CONCLUSIONS
These results suggest that patients with high PG are likely to have high concentrations of plasma glucagon, which may aggravate glycemic control progressively, leading to elevation of HbA1c levels.
Urakami
Tatsuhiko
T
Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan. turakami@med.nihon-u.ac.jp
Nagano
Nobuhiko
N
Suzuki
Junichi
J
Yoshida
Ayako
A
Takahashi
Shori
S
Mugishima
Hideo
H
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D005934:Glucagon / Q000097:blood*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D050417:Insulin-Secreting Cells / Q000378:metabolism; D007564:Japan; D008297:Male
D015415:Biomarkers; D001786:Blood Glucose; D005934:Glucagon; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human