The Pathological Evolution of Glucose Response Curves During the Progression to Type 1 Diabetes in the TrialNet Pathway to Prevention Study
| Autor: | Jennifer B. Marks, Mario A Cleves, Dorothy J. Becker, Jerry P. Palmer, Ingrid Libman, Ping Xu, Heba M. Ismail, Jay S. Skyler, Jay M. Sosenko |
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| Rok vydání: | 2020 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Gastroenterology 03 medical and health sciences Young Adult 0302 clinical medicine Internal medicine Diabetes mellitus Insulin-Secreting Cells Internal Medicine medicine Humans Family 030212 general & internal medicine Longitudinal Studies Oral glucose tolerance Epidemiology/Health Services Research skin and connective tissue diseases Child Pathological Pancreas Autoantibodies Advanced and Specialized Nursing Type 1 diabetes C-Peptide Extramural business.industry Glucose Tolerance Test medicine.disease Prevention Study Diabetes Mellitus Type 1 Child Preschool Disease Progression Female sense organs business Follow-Up Studies |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 |
| Popis: | OBJECTIVE Glucose response curves (GRCs) during oral glucose tolerance tests (OGTTs) are predictive of type 1 diabetes. We performed a longitudinal analysis in pancreatic autoantibody-positive individuals to assess 1) characteristic GRC changes during progression to type 1 diabetes and 2) GRC changes in relation to β-cell function changes and to combined glucose and C-peptide response curve (GCRC) changes. RESEARCH DESIGN AND METHODS Among antibody-positive individuals with serial OGTTs in the TrialNet Pathway to Prevention study, GRC changes from first to last OGTTs were compared between progressors (n = 298) to type 1 diabetes and nonprogressors (n = 2,216). GRC changes from last OGTT before diagnosis to diagnostic OGTTs were studied in progressors. RESULTS GRCs changed more frequently from biphasic (two peaks) to monophasic (one peak) GRCs between first and last OGTTs in progressors than in nonprogressors (75.4% vs. 51.0%, respectively; P < 0.001). In contrast, GRCs of progressors changed less frequently from monophasic to biphasic than those of nonprogressors (12.6% vs. 30.6%; P < 0.001). Monotonic (continuous increase) GRCs were present in 47.7% of progressors at diagnosis. The early (30–0 min) C-peptide response decreased in progressors with GRCs changing from biphasic to monophasic between first and last OGTTs (P < 0.001) and from monophasic to monotonic between last and diagnostic OGTTs (P < 0.001). Conversely, the early C-peptide response increased among nonprogressors with GRCs changing from monophasic to biphasic (P < 0.001). Changes in GRCs were related to changes in GCRCs. CONCLUSIONS Characteristic GRC changes, biphasic to monophasic to monotonic, occur during the progression to type 1 diabetes. These GRC changes correspond to decreasing β-cell function. |
| Databáze: | OpenAIRE |
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