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C-peptide in the classification of diabetes in children and adolescents.

Ludvigsson, Johnny; Carlsson, Annelie LU ; Forsander, G; Ivarsson, Sten LU ; Kockum, I; Lernmark, Åke LU ; Lindblad, Bengt LU ; Marcus, C and Samuelsson, U (2012) In Pediatric Diabetes 13. p.45-50
Abstract
C-peptide in the classification of diabetes in children and adolescents. Aim: To report C-peptide results in newly diagnosed patients and the relation to clinical diagnosis of diabetes. Methods: A nation-wide cohort, the Better Diabetes Diagnosis study was used to determine serum C-peptide at diagnosis in 2734 children and adolescents. Clinical data were collected at diagnosis and follow-up. C-peptide was determined in a validated and controlled time-resolved fluoroimmunoassay. Results: The clinical classification of diabetes, before any information on human leukocyte antigen, islet autoantibodies, or C-peptide was received, was type 1 diabetes (T1D) in 93%, type 2 diabetes (T2D) in 1.9%, maturity onset diabetes of the young (MODY) in... (More)
C-peptide in the classification of diabetes in children and adolescents. Aim: To report C-peptide results in newly diagnosed patients and the relation to clinical diagnosis of diabetes. Methods: A nation-wide cohort, the Better Diabetes Diagnosis study was used to determine serum C-peptide at diagnosis in 2734 children and adolescents. Clinical data were collected at diagnosis and follow-up. C-peptide was determined in a validated and controlled time-resolved fluoroimmunoassay. Results: The clinical classification of diabetes, before any information on human leukocyte antigen, islet autoantibodies, or C-peptide was received, was type 1 diabetes (T1D) in 93%, type 2 diabetes (T2D) in 1.9%, maturity onset diabetes of the young (MODY) in 0.8%, secondary diabetes (0.6%), while 3.3% could not be classified. In a random, non-fasting serum sample at diagnosis, 56% of the patients had a C-peptide value >0.2 nmol/L. Children classified as T2D had the highest mean C-peptide (1.83 + 1.23 nmol/L) followed by MODY (1.04 ± 0.71 nmol/L) and T1D (0.28 ± 0.25 nmol/L). Only 1/1037 children who had C-peptide <0.2 nmol/L at diagnosis was classified with a type of diabetes other than T1D. Predictive value of C-peptide >1.0 nmol/L for the classification of either T2D or MODY was 0.46 [confidence interval 0.37-0.58]. Conclusions: More than half of children with newly diagnosed diabetes have clinically important residual beta-cell function. As the clinical diagnosis is not always straightforward, a random C-peptide taken at diagnosis may help to classify diabetes. There is an obvious use for C-peptide determinations to evaluate beta-cell function in children with diabetes. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Pediatric Diabetes
volume
13
pages
45 - 50
publisher
Wiley-Blackwell
external identifiers
  • wos:000299549900008
  • pmid:21910810
  • scopus:84856406466
ISSN
1399-543X
DOI
10.1111/j.1399-5448.2011.00807.x
language
English
LU publication?
yes
id
285cccbc-6990-4669-b25f-0664d5bfa6c5 (old id 2168965)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21910810?dopt=Abstract
date added to LUP
2011-10-03 10:16:08
date last changed
2017-11-09 14:01:31
@article{285cccbc-6990-4669-b25f-0664d5bfa6c5,
  abstract     = {C-peptide in the classification of diabetes in children and adolescents. Aim: To report C-peptide results in newly diagnosed patients and the relation to clinical diagnosis of diabetes. Methods: A nation-wide cohort, the Better Diabetes Diagnosis study was used to determine serum C-peptide at diagnosis in 2734 children and adolescents. Clinical data were collected at diagnosis and follow-up. C-peptide was determined in a validated and controlled time-resolved fluoroimmunoassay. Results: The clinical classification of diabetes, before any information on human leukocyte antigen, islet autoantibodies, or C-peptide was received, was type 1 diabetes (T1D) in 93%, type 2 diabetes (T2D) in 1.9%, maturity onset diabetes of the young (MODY) in 0.8%, secondary diabetes (0.6%), while 3.3% could not be classified. In a random, non-fasting serum sample at diagnosis, 56% of the patients had a C-peptide value &gt;0.2 nmol/L. Children classified as T2D had the highest mean C-peptide (1.83 + 1.23 nmol/L) followed by MODY (1.04 ± 0.71 nmol/L) and T1D (0.28 ± 0.25 nmol/L). Only 1/1037 children who had C-peptide &lt;0.2 nmol/L at diagnosis was classified with a type of diabetes other than T1D. Predictive value of C-peptide &gt;1.0 nmol/L for the classification of either T2D or MODY was 0.46 [confidence interval 0.37-0.58]. Conclusions: More than half of children with newly diagnosed diabetes have clinically important residual beta-cell function. As the clinical diagnosis is not always straightforward, a random C-peptide taken at diagnosis may help to classify diabetes. There is an obvious use for C-peptide determinations to evaluate beta-cell function in children with diabetes.},
  author       = {Ludvigsson, Johnny and Carlsson, Annelie and Forsander, G and Ivarsson, Sten and Kockum, I and Lernmark, Åke and Lindblad, Bengt and Marcus, C and Samuelsson, U},
  issn         = {1399-543X},
  language     = {eng},
  pages        = {45--50},
  publisher    = {Wiley-Blackwell},
  series       = {Pediatric Diabetes},
  title        = {C-peptide in the classification of diabetes in children and adolescents.},
  url          = {http://dx.doi.org/10.1111/j.1399-5448.2011.00807.x},
  volume       = {13},
  year         = {2012},
}