title: Changes in beta cell function during the proximate post-diagnosis period in persons with type 1 diabetes.
abstract: Prior studies examining beta-cell preservation in type 1 diabetes have predominantly assessed stimulated C-peptide concentrations approximately 10 wk after diagnosis. We examined whether earlier assessments might aid in prediction of beta cell function over time.
  
  
  
  Using data from a multi-center randomized trial assessing the effect of intensive diabetes management initiated within 1 wk of diagnosis, we assessed which clinical factors predicted 90-min mixed-meal tolerance test (MMTT) stimulated C-peptide values obtained 2 and 6 wk after diagnosis. We also studied associations of these factors with C-peptide values at 1- and 2-year post-diagnosis. Data from intervention and control groups were pooled.
  
  
  
  Among 67 study participants (mean age 13.3 ± 5.7 yr, range 7.8-45.7 yr) in multivariable analyses, C-peptide increased from baseline to 2 wks and then 6 wk. C-peptide levels at these times were significantly correlated with 1- and 2-yr C-peptide concentrations (all p < 0.001), with the strongest observed associations between 6-wk C-peptide and the 1- and 2-yr values (r = 0.66 and r = 0.61, respectively). In multivariable analyses, greater baseline and 6-wk C-peptide, and older age independently predicted greater 1- and 2-yr C-peptide concentrations.
  
  
  
  C-peptide assessments close to diagnosis were predictive of subsequent C-peptide production. Our data demonstrate a clear increase in C-peptide over the initial 6 wk after diabetes diagnosis followed by a plateau. Our data do not suggest that MMTT assessments performed closer to diagnosis than 6 wk would improve prediction of subsequent residual beta cell function.
authors.affiliation: Department of Pediatrics, Section of Pediatric Endocrinology/Diabetology, Indiana University, Riley Hospital for Children, Indianapolis, IN, USA.
authors.forename: Linda A
authors.initials: LA
authors.lastname: DiMeglio
authors.affiliation: Jaeb Center for Health Research, Tampa, FL, USA.
authors.forename: Peiyao
authors.initials: P
authors.lastname: Cheng
authors.affiliation: Jaeb Center for Health Research, Tampa, FL, USA.
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.affiliation: Jaeb Center for Health Research, Tampa, FL, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Kollman
authors.affiliation: Jaeb Center for Health Research, Tampa, FL, USA.
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Ruedy
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Slover
authors.affiliation: Pediatric Endocrinology, Stanford University, Stanford, CA, USA.
authors.forename: Tandy
authors.initials: T
authors.lastname: Aye
authors.affiliation: Pediatric Endocrinology, Yale University, New Haven, CT, USA.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Weinzimer
authors.affiliation: Division of Pediatric Endocrinology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Bremer
authors.affiliation: Pediatric Endocrinology, Stanford University, Stanford, CA, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Buckingham
mesh_terms: D000293:Adolescent; D000328:Adult; D002096:C-Peptide / Q000097:blood*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D050417:Insulin-Secreting Cells / Q000502:physiology*; D008875:Middle Aged; D055815:Young Adult
chemical_list: D002096:C-Peptide
keywords: clinical science; diabetes in childhood; insulin secretions in vivo