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Decline of C-peptide during the first year after diagnosis of Type 1 diabetes in children and adolescents

Ludvigsson, Johnny; Carlsson, Annelie LU ; Deli, Ahmed; Forsander, Gun; Ivarsson, Sten LU ; Kockum, Ingrid; Lindblad, Bengt LU ; Marcus, Claude; Lernmark, Ake LU and Samuelsson, Ulf (2013) In Diabetes Research and Clinical Practice 100(2). p.203-209
Abstract
Aims/hypothesis: We studied the decline of C-peptide during the first year after diagnosis of Type 1 diabetes (T1D), and its relation to various factors. Methods: 3824/4017 newly diagnosed patients (95%) were classified as T1D in a national study. In a non-selected subgroup of 1669 T1D patients we determined non-fasting C-peptide both at diagnosis and after 1 year, and analyzed decline in relation to clinical symptoms and signs, initial C-peptide and occurrence of auto-antibodies. Results: Younger children lost more C-peptide (p < 0.001) and the higher the C-peptide at diagnosis the larger the decline during the first year (p < 0.0000). Patients with higher BMI had higher C-peptide at diagnosis but lost more (p < 0.01), and those... (More)
Aims/hypothesis: We studied the decline of C-peptide during the first year after diagnosis of Type 1 diabetes (T1D), and its relation to various factors. Methods: 3824/4017 newly diagnosed patients (95%) were classified as T1D in a national study. In a non-selected subgroup of 1669 T1D patients we determined non-fasting C-peptide both at diagnosis and after 1 year, and analyzed decline in relation to clinical symptoms and signs, initial C-peptide and occurrence of auto-antibodies. Results: Younger children lost more C-peptide (p < 0.001) and the higher the C-peptide at diagnosis the larger the decline during the first year (p < 0.0000). Patients with higher BMI had higher C-peptide at diagnosis but lost more (p < 0.01), and those with lower HbA1c, without symptoms and signs at diagnosis, and with higher BMI, had higher C-peptide at diagnosis, but lost more during the first year (p < 0.001). Finally, patients diagnosed during autumn had higher C-peptide at diagnosis, but lost more during the coming year (p < 0.001). Occurrence of auto-antibodies did not correlate with C-peptide decline, except possibly for a more rapid loss in IAA-positive patients. Conclusions/interpretation: Even in a restricted geographical area and narrow age range (< 18 years), the natural course of Type 1 diabetes is heterogeneous. This should be considered in clinical trials. (C) 2013 Elsevier Ireland Ltd. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
C-peptide, Natural course, Type 1 diabetes, Children, BMI, Intervention, trials
in
Diabetes Research and Clinical Practice
volume
100
issue
2
pages
203 - 209
publisher
Elsevier
external identifiers
  • wos:000320590900016
  • scopus:84878376574
ISSN
1872-8227
DOI
10.1016/j.diabres.2013.03.003
language
English
LU publication?
yes
id
b9eb6ff1-a724-4721-8528-8a029091ee60 (old id 3979227)
date added to LUP
2013-09-02 07:31:57
date last changed
2018-12-02 03:03:38
@article{b9eb6ff1-a724-4721-8528-8a029091ee60,
  abstract     = {Aims/hypothesis: We studied the decline of C-peptide during the first year after diagnosis of Type 1 diabetes (T1D), and its relation to various factors. Methods: 3824/4017 newly diagnosed patients (95%) were classified as T1D in a national study. In a non-selected subgroup of 1669 T1D patients we determined non-fasting C-peptide both at diagnosis and after 1 year, and analyzed decline in relation to clinical symptoms and signs, initial C-peptide and occurrence of auto-antibodies. Results: Younger children lost more C-peptide (p &lt; 0.001) and the higher the C-peptide at diagnosis the larger the decline during the first year (p &lt; 0.0000). Patients with higher BMI had higher C-peptide at diagnosis but lost more (p &lt; 0.01), and those with lower HbA1c, without symptoms and signs at diagnosis, and with higher BMI, had higher C-peptide at diagnosis, but lost more during the first year (p &lt; 0.001). Finally, patients diagnosed during autumn had higher C-peptide at diagnosis, but lost more during the coming year (p &lt; 0.001). Occurrence of auto-antibodies did not correlate with C-peptide decline, except possibly for a more rapid loss in IAA-positive patients. Conclusions/interpretation: Even in a restricted geographical area and narrow age range (&lt; 18 years), the natural course of Type 1 diabetes is heterogeneous. This should be considered in clinical trials. (C) 2013 Elsevier Ireland Ltd. All rights reserved.},
  author       = {Ludvigsson, Johnny and Carlsson, Annelie and Deli, Ahmed and Forsander, Gun and Ivarsson, Sten and Kockum, Ingrid and Lindblad, Bengt and Marcus, Claude and Lernmark, Ake and Samuelsson, Ulf},
  issn         = {1872-8227},
  keyword      = {C-peptide,Natural course,Type 1 diabetes,Children,BMI,Intervention,trials},
  language     = {eng},
  number       = {2},
  pages        = {203--209},
  publisher    = {Elsevier},
  series       = {Diabetes Research and Clinical Practice},
  title        = {Decline of C-peptide during the first year after diagnosis of Type 1 diabetes in children and adolescents},
  url          = {http://dx.doi.org/10.1016/j.diabres.2013.03.003},
  volume       = {100},
  year         = {2013},
}