Residual β-Cell Function 3 to 6 Years After Onset of Type 1 Diabetes Reduces Risk of Severe Hypoglycemia in Children and Adolescents
| Autor: | Sorensen, J. S., Johannesen, J., Pociot, F., Kristensen, K., Thomsen, Jane, Hertel, N. T., Kjaersgaard, P., Brorsson, C., Birkebaek, N. H., Danish Soc Diabet, Childhood |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Blood Glucose
Male Endocrinology Diabetes and Metabolism medicine.medical_treatment Gastroenterology chemistry.chemical_compound Insulin-Secreting Cells Insulin Registries Child Meals reproductive and urinary physiology Original Research C-Peptide C-peptide Clinical Care/Education/Nutrition/Psychosocial Research Insulin/therapeutic use Child Preschool cardiovascular system Hypoglycemia/drug therapy Female circulatory and respiratory physiology Insulin-Secreting Cells/physiology medicine.medical_specialty Adolescent Diabetes Mellitus Type 1/drug therapy Hypoglycemic Agents/therapeutic use MEAL TOLERANCE-TEST C-PEPTIDE CLINICAL-MANIFESTATIONS METABOLIC CONTROL GLYCEMIC CONTROL RISING INCIDENCE NATURAL-HISTORY MELLITUS AUTOANTIBODIES REMISSION Hypoglycemia Lower risk Internal medicine Diabetes mellitus Internal Medicine medicine Humans Hypoglycemic Agents Glycemic Advanced and Specialized Nursing Type 1 diabetes Blood Glucose/metabolism business.industry urogenital system Odds ratio medicine.disease Endocrinology C-Peptide/analysis Diabetes Mellitus Type 1 chemistry business |
| Zdroj: | Sorensen, J S, Johannesen, J, Pociot, F, Kristensen, K, Thomsen, J, Hertel, N T, Kjaersgaard, P, Brorsson, C, Birkebaek, N H & the Danish Society for Diabetes in Childhood and Adolescence 2013, ' Residual β-Cell Function 3 to 6 Years After Onset of Type 1 Diabetes Reduces Risk of Severe Hypoglycemia in Children and Adolescents ', Diabetes Care . https://doi.org/10.2337/dc13-0418 Diabetes Care Sorensen, J S, Johannesen, J, Pociot, F, Kristensen, K, Thomsen, J, Hertel, N T, Kjaersgaard, P, Brorsson, C, Birkebaek, N H & Danish Soc Diabet, C 2013, ' Residual β-cell function 3-6 years after onset of type 1 diabetes reduces risk of severe hypoglycemia in children and adolescents ', Diabetes Care, vol. 36, no. 11, pp. 3454-3459 . https://doi.org/10.2337/dc13-0418 |
| DOI: | 10.2337/dc13-0418 |
| Popis: | OBJECTIVE To determine the prevalence of residual β-cell function (RBF) in children after 3–6 years of type 1 diabetes, and to examine the association between RBF and incidence of severe hypoglycemia, glycemic control, and insulin requirements. RESEARCH DESIGN AND METHODS A total of 342 children (173 boys) 4.8–18.9 years of age with type 1 diabetes for 3–6 years were included. RBF was assessed by testing meal-stimulated C-peptide concentrations. Information regarding severe hypoglycemia within the past year, current HbA1c, and daily insulin requirements was retrieved from the medical records and through patient interviews. RESULTS Ninety-two children (27%) had RBF >0.04 nmol/L. Patients with RBF 0.04 nmol/L (odds ratio, 2.59; 95% CI, 1.10–7.08; P < 0.03). HbA1c was significantly higher in patients with RBF 0.04 nmol/L (mean, 8.49 ± 0.08% [69.3 ± 0.9 mmol/mol] vs. 7.92 ± 0.13% [63.1 ± 1.4 mmol/mol]; P < 0.01), and insulin requirements were significantly lower in patients with RBF >0.2 nmol/L (mean ± SE: 1.07 ± 0.02 vs. 0.93 ± 0.07 units/kg/day; P < 0.04). CONCLUSIONS We demonstrated considerable phenotypic diversity in RBF among children after 3–6 years of type 1 diabetes. Children with RBF are at lower risk for severe hypoglycemia, have better diabetes regulation, and have lower insulin requirements compared with children without RBF. There appears to be a lower limit for stimulated RBF of ∼0.04 nmol/L that confers a beneficial effect on hypoglycemia and metabolic control. |
| Databáze: | OpenAIRE |
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