Limits...
Glucose and C-peptide changes in the perionset period of type 1 diabetes in the Diabetes Prevention Trial-Type 1.

Sosenko JM, Palmer JP, Rafkin-Mervis L, Krischer JP, Cuthbertson D, Matheson D, Skyler JS - Diabetes Care (2008)

Bottom Line: Peak C-peptide levels fell substantially between the OGTTs (median change -14.3%, P < 0.001).Among those same individuals the median change in peak C-peptide levels from the last normal OGTT to the confirmatory OGTT (interval 7.5 +/- 1.3 months) was -23.8% (P < 0.001).It seems that postchallenge C-peptide levels begin to decrease appreciably in the 6 months before diagnosis and decrease even more rapidly within 3 months after diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology, University of Miami, Miami, Florida, USA. jsosenko@med.miami.edu

ABSTRACT

Objective: We examined metabolic changes in the period immediately after the diagnosis of type 1 diabetes and in the period leading up to its diagnosis in Diabetes Prevention Trial-Type 1 (DPT-1) participants.

Research design and methods: The study included oral insulin trial participants and parenteral insulin trial control subjects (n = 63) in whom diabetes was diagnosed by a 2-h diabetic oral glucose tolerance test (OGTT) that was confirmed by another diabetic OGTT within 3 months. Differences in glucose and C-peptide levels between the OGTTs were assessed.

Results: Glucose levels increased at 90 (P = 0.006) and 120 min (P < 0.001) from the initial diabetic OGTT to the confirmatory diabetic OGTT (mean +/- SD interval 5.5 +/- 2.8 weeks). Peak C-peptide levels fell substantially between the OGTTs (median change -14.3%, P < 0.001). Among the 55 individuals whose last nondiabetic OGTT was approximately 6 months before the initial diabetic OGTT, peak C-peptide levels decreased between these two OGTTs (median change -14.0%, P = 0.052). Among those same individuals the median change in peak C-peptide levels from the last normal OGTT to the confirmatory OGTT (interval 7.5 +/- 1.3 months) was -23.8% (P < 0.001). Median rates of change in peak C-peptide levels were 0.00 ng x ml(-1) x month(-1) (P = 0.468, n = 36) from approximately 12 to 6 months before diagnosis, -0.10 ng x ml(-1) x month(-1) (P = 0.059, n = 55) from 6 months before diagnosis to diagnosis, and -0.43 ng x ml(-1) x month(-1) (P = 0.002, n = 63) from the initial diabetic OGTT to the confirmatory diabetic OGTT.

Conclusions: It seems that postchallenge C-peptide levels begin to decrease appreciably in the 6 months before diagnosis and decrease even more rapidly within 3 months after diagnosis.

Show MeSH

Related in: MedlinePlus

A: Percent changes in glucose indexes after diagnosis. Shown are the medians for the percent changes of glucose indexes from the initial diabetic OGTT to the confirmatory diabetic OGTT. Glucose levels tended to increase, especially at the later time points of the OGTT. B: Percent changes in C-peptide indexes after diagnosis. Shown are the medians for the percent changes of C-peptide indexes from the initial diabetic OGTT to the confirmatory diabetic OGTT. With the exception of the fasting C-peptide, there was a >10% median decline for all of the indexes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2571043&req=5

f1: A: Percent changes in glucose indexes after diagnosis. Shown are the medians for the percent changes of glucose indexes from the initial diabetic OGTT to the confirmatory diabetic OGTT. Glucose levels tended to increase, especially at the later time points of the OGTT. B: Percent changes in C-peptide indexes after diagnosis. Shown are the medians for the percent changes of C-peptide indexes from the initial diabetic OGTT to the confirmatory diabetic OGTT. With the exception of the fasting C-peptide, there was a >10% median decline for all of the indexes.

Mentions: Table 1 shows glucose levels for the initial and confirmatory OGTTs. There was a tendency for glucose levels to increase between the first diabetic OGTT and the confirmatory diabetic OGTT with statistically significant increases at 90 (P = 0.006) and 120 min (P < 0.001) and for AUC glucose (P = 0.016). Figure 1A shows the corresponding percent changes.


Glucose and C-peptide changes in the perionset period of type 1 diabetes in the Diabetes Prevention Trial-Type 1.

Sosenko JM, Palmer JP, Rafkin-Mervis L, Krischer JP, Cuthbertson D, Matheson D, Skyler JS - Diabetes Care (2008)

A: Percent changes in glucose indexes after diagnosis. Shown are the medians for the percent changes of glucose indexes from the initial diabetic OGTT to the confirmatory diabetic OGTT. Glucose levels tended to increase, especially at the later time points of the OGTT. B: Percent changes in C-peptide indexes after diagnosis. Shown are the medians for the percent changes of C-peptide indexes from the initial diabetic OGTT to the confirmatory diabetic OGTT. With the exception of the fasting C-peptide, there was a >10% median decline for all of the indexes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2571043&req=5

f1: A: Percent changes in glucose indexes after diagnosis. Shown are the medians for the percent changes of glucose indexes from the initial diabetic OGTT to the confirmatory diabetic OGTT. Glucose levels tended to increase, especially at the later time points of the OGTT. B: Percent changes in C-peptide indexes after diagnosis. Shown are the medians for the percent changes of C-peptide indexes from the initial diabetic OGTT to the confirmatory diabetic OGTT. With the exception of the fasting C-peptide, there was a >10% median decline for all of the indexes.
Mentions: Table 1 shows glucose levels for the initial and confirmatory OGTTs. There was a tendency for glucose levels to increase between the first diabetic OGTT and the confirmatory diabetic OGTT with statistically significant increases at 90 (P = 0.006) and 120 min (P < 0.001) and for AUC glucose (P = 0.016). Figure 1A shows the corresponding percent changes.

Bottom Line: Peak C-peptide levels fell substantially between the OGTTs (median change -14.3%, P < 0.001).Among those same individuals the median change in peak C-peptide levels from the last normal OGTT to the confirmatory OGTT (interval 7.5 +/- 1.3 months) was -23.8% (P < 0.001).It seems that postchallenge C-peptide levels begin to decrease appreciably in the 6 months before diagnosis and decrease even more rapidly within 3 months after diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology, University of Miami, Miami, Florida, USA. jsosenko@med.miami.edu

ABSTRACT

Objective: We examined metabolic changes in the period immediately after the diagnosis of type 1 diabetes and in the period leading up to its diagnosis in Diabetes Prevention Trial-Type 1 (DPT-1) participants.

Research design and methods: The study included oral insulin trial participants and parenteral insulin trial control subjects (n = 63) in whom diabetes was diagnosed by a 2-h diabetic oral glucose tolerance test (OGTT) that was confirmed by another diabetic OGTT within 3 months. Differences in glucose and C-peptide levels between the OGTTs were assessed.

Results: Glucose levels increased at 90 (P = 0.006) and 120 min (P < 0.001) from the initial diabetic OGTT to the confirmatory diabetic OGTT (mean +/- SD interval 5.5 +/- 2.8 weeks). Peak C-peptide levels fell substantially between the OGTTs (median change -14.3%, P < 0.001). Among the 55 individuals whose last nondiabetic OGTT was approximately 6 months before the initial diabetic OGTT, peak C-peptide levels decreased between these two OGTTs (median change -14.0%, P = 0.052). Among those same individuals the median change in peak C-peptide levels from the last normal OGTT to the confirmatory OGTT (interval 7.5 +/- 1.3 months) was -23.8% (P < 0.001). Median rates of change in peak C-peptide levels were 0.00 ng x ml(-1) x month(-1) (P = 0.468, n = 36) from approximately 12 to 6 months before diagnosis, -0.10 ng x ml(-1) x month(-1) (P = 0.059, n = 55) from 6 months before diagnosis to diagnosis, and -0.43 ng x ml(-1) x month(-1) (P = 0.002, n = 63) from the initial diabetic OGTT to the confirmatory diabetic OGTT.

Conclusions: It seems that postchallenge C-peptide levels begin to decrease appreciably in the 6 months before diagnosis and decrease even more rapidly within 3 months after diagnosis.

Show MeSH
Related in: MedlinePlus