Associations of HbA1c with the timing of C-peptide responses during the oral glucose tolerance test at the diagnosis of type 1 diabetes.
| Autor: | Ismail HM; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana., Evans-Molina C; Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana., DiMeglio LA; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana., Becker DJ; Division of Endocrinology and Metabolism, University of Pittsburgh and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania., Libman I; Division of Endocrinology and Metabolism, University of Pittsburgh and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania., Sims EK; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana., Boulware D; Department of Bio-statistics, H. Lee Moffitt Cancer Center, Tampa, Florida., Herold KC; Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut., Rafkin L; Division of Endocrinology, Diabetes, and Metabolism, University of Miami, Miami, Florida., Skyler J; Division of Endocrinology, Diabetes, and Metabolism, University of Miami, Miami, Florida., Cleves MA; Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida., Palmer J; Department of Medicine, VA Puget Sound Health Care System, Seattle, Washington.; Department of Medicine, University of Washington, Seattle, Washington., Sosenko JM; Division of Endocrinology, Diabetes, and Metabolism, University of Miami, Miami, Florida. |
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| Jazyk: | angličtina |
| Zdroj: | Pediatric diabetes [Pediatr Diabetes] 2019 Jun; Vol. 20 (4), pp. 408-413. Date of Electronic Publication: 2019 Apr 15. |
| DOI: | 10.1111/pedi.12845 |
| Abstrakt: | Background: In new onset type 1 diabetes (T1D), overall C-peptide measures such as area under the curve (AUC) C-peptide and peak C-peptide are useful for estimating the extent of β-cell dysfunction, and for assessing responses to intervention therapy. However, measures of the timing of C-peptide responsiveness could have additional value. Objectives: We assessed the contribution of the timing of C-peptide responsiveness during oral glucose tolerance tests (OGTTs) to hemoglobin A1c (HbA1c) variation at T1D diagnosis. Methods: We analyzed data from 85 individuals <18 years with OGTTs and HbA1c measurements at diagnosis. Overall [AUC and peak C-peptide] and timing measures [30-0 minute C-peptide (early); 60 to 120 minute C-peptide sum-30 minutes (late); 120/30 C-peptide; time to peak C-peptide] were utilized. Results: At diagnosis, the mean (±SD) age was 11.2 ± 3.3 years, body mass index (BMI)-z was 0.4 ± 1.1, 51.0% were male. The average HbA1c was 43.54 ± 8.46 mmol/mol (6.1 ± 0.8%). HbA1c correlated inversely with the AUC C-peptide (P < 0.001), peak C-peptide (P < 0.001), early and late C-peptide responses (P < 0.001 each), and 120/30 C-peptide (P < 0.001). Those with a peak C-peptide occurring at ≤60 minutes had higher HbA1c values than those with peaks later (P = 0.003). HbA1c variance was better explained with timing measures added to regression models (R 2 = 11.6% with AUC C-peptide alone; R 2 = 20.0% with 120/30 C-peptide added; R 2 = 13.7% with peak C-peptide alone, R 2 = 20.4% with timing of the peak added). Similar associations were seen between the 2-hour glucose and the C-peptide measures. Conclusions: These findings show that the addition of timing measures of C-peptide responsiveness better explains HbA1c variation at diagnosis than standard measures alone. (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.) |
| Databáze: | MEDLINE |
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