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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.

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Related in: MedlinePlus

Rates of change in peak C-peptide in the perionset period. Shown are the rates of change of peak C-peptide levels according to intervals before and after diagnosis. C-peptide levels changed minimally between ∼12 and 6 months before diagnosis. There was a decline in the 6 months before diagnosis that was more substantial in the period after diagnosis.
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f3: Rates of change in peak C-peptide in the perionset period. Shown are the rates of change of peak C-peptide levels according to intervals before and after diagnosis. C-peptide levels changed minimally between ∼12 and 6 months before diagnosis. There was a decline in the 6 months before diagnosis that was more substantial in the period after diagnosis.

Mentions: Figure 3 shows the median rates of change in peak C-peptide levels over intervals in the perionset period. The values were obtained by dividing the difference in peak C-peptide values for an interval by the length of the interval. There was minimal change (0.00 ng · ml−1 · month−1, P = 0.468, n = 36) in peak C-peptide from ∼12 to 6 months before diagnosis. There was a decline in peak C-peptide levels from 6 months before diagnosis to diagnosis (−0.10 ng · ml−1 · month−1, P = 0.059, n = 55) and an even greater rate of decline from diagnosis to within 3 months after diagnosis (−0.43 ng · ml−1 · month−1, P = 0.002, n = 63).


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)

Rates of change in peak C-peptide in the perionset period. Shown are the rates of change of peak C-peptide levels according to intervals before and after diagnosis. C-peptide levels changed minimally between ∼12 and 6 months before diagnosis. There was a decline in the 6 months before diagnosis that was more substantial in the period after diagnosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f3: Rates of change in peak C-peptide in the perionset period. Shown are the rates of change of peak C-peptide levels according to intervals before and after diagnosis. C-peptide levels changed minimally between ∼12 and 6 months before diagnosis. There was a decline in the 6 months before diagnosis that was more substantial in the period after diagnosis.
Mentions: Figure 3 shows the median rates of change in peak C-peptide levels over intervals in the perionset period. The values were obtained by dividing the difference in peak C-peptide values for an interval by the length of the interval. There was minimal change (0.00 ng · ml−1 · month−1, P = 0.468, n = 36) in peak C-peptide from ∼12 to 6 months before diagnosis. There was a decline in peak C-peptide levels from 6 months before diagnosis to diagnosis (−0.10 ng · ml−1 · month−1, P = 0.059, n = 55) and an even greater rate of decline from diagnosis to within 3 months after diagnosis (−0.43 ng · ml−1 · month−1, P = 0.002, n = 63).

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