Residual beta cell function at diagnosis of type 1 diabetes in children and adolescents varies with gender and season.
BACKGROUND
There are seasonal variations and gender differences in incidence of type 1 diabetes (T1D), metabolic control and responses to immune interventions at onset of the disease. We hypothesized that there are seasonal and gender differences in residual insulin secretion already at diagnosis of T1D.


METHODS
In 2005, a national study, the Better Diabetes Diagnosis, was started to classify all newly diagnosed children and adolescents with diabetes. About 95% (3824/4017) of the patients were classified as T1D, and our analyses are based on the patients with T1D.


RESULTS
C-peptide was lower in younger children, 0-10 years of age (0.23 ± 0.20 nmol/L) than in older children, 11-18 years of age (0.34 ± 0.28 nmol/L) (p < 0.000 ). There was a seasonal variation in non-fasting serum C-peptide, significantly correlated to the seasonal variation of diagnosis (p < 0.01). Most children were diagnosed in January, February and March as well as in October when C-peptide was highest, whereas fewer patients were diagnosed in April and May when serum C-peptide was significantly lower (p < 0.01). The seasonal variation of C-peptide was more pronounced in boys than in girls (p < 0.000 and p < 0.01, respectively). Girls had higher C-peptide than boys (p < 0.05), especially in early puberty.


CONCLUSIONS
Both seasonal and gender differences in residual beta cell function exist already at diagnosis of T1D. These observations have consequences for treatment and for randomizing patients in immune intervention clinical trials.
Department of Clinical and Experimental Medicine, Division of Pediatrics and Diabetes, Research Center, Linköping University Hospital, Linköping, Sweden. ulf.samuelsson@lio.se
U
U
Samuelsson
B
B
Lindblad
A
A
Carlsson
G
G
Forsander
S
S
Ivarsson
I
I
Kockum
Å
Å
Lernmark
C
C
Marcus
J
J
Ludvigsson
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007223:Infant; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D008297:Male; D011446:Prospective Studies; D012621:Seasons; D012727:Sex Characteristics
D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin