Age-dependent decline of β cell function in type 1 diabetes after diagnosis: a multi-centre longitudinal study

TY - JOUR

T1 - Age-dependent decline of β cell function in type 1 diabetes after diagnosis

T2 - a multi-centre longitudinal study

AU - Barker, Vincent A.

AU - Lauria, A

AU - Schloot, N

AU - Hosszufalusi, N

AU - Ludvigsson, J

AU - Mathieu, Christopher John

AU - Mauricio, D

AU - Nordwall, M

AU - Van der Schueren, B

AU - Mandrup-Poulsen, Thomas

AU - Scherbaum, Wa

AU - Weets, I

AU - Gorus, Fk

AU - Wareham, N

AU - Leslie, Rd

AU - Pozzilli, P

N1 - This article is protected by copyright. All rights reserved.

PY - 2014/3

Y1 - 2014/3

N2 - Aims: C-peptide secretion is currently the only available clinical biomarker to measure residual β-cell function in type 1 diabetes. However, the natural history of C-peptide decline after diagnosis can vary considerably dependent upon several variables. We investigated the shape of C-peptide decline over time from type 1 diabetes onset in relation to age at diagnosis, haemoglobin A1c (HbA1c) levels and insulin dose. Methods: We analysed data from 3929 type 1 diabetes patients recruited from seven European centres representing all age groups at disease onset (childhood, adolescence and adulthood). The influence of the age at onset on β-cell function was investigated in a longitudinal analysis at diagnosis and up to 5-years follow-up. Results: Fasting C-peptide (FCP) data at diagnosis were available in 3668 patients stratified according to age at diagnosis in four groups (<5years, n=344; >5years<10years, n=668; >10years<18years, n=991; >18years, n=1655). FCP levels were positively correlated with age (p<0.001); the subsequent decline in FCP over time was log-linear with a greater decline rate in younger age groups (p<0.0001). Conclusions: This study reveals a positive correlation between age at diagnosis of type 1 diabetes and FCP with a more rapid decline of β-cell function in the very young patients. These data can inform the design of clinical trials using C-peptide values as an end-point for the effect of a given treatment.

AB - Aims: C-peptide secretion is currently the only available clinical biomarker to measure residual β-cell function in type 1 diabetes. However, the natural history of C-peptide decline after diagnosis can vary considerably dependent upon several variables. We investigated the shape of C-peptide decline over time from type 1 diabetes onset in relation to age at diagnosis, haemoglobin A1c (HbA1c) levels and insulin dose. Methods: We analysed data from 3929 type 1 diabetes patients recruited from seven European centres representing all age groups at disease onset (childhood, adolescence and adulthood). The influence of the age at onset on β-cell function was investigated in a longitudinal analysis at diagnosis and up to 5-years follow-up. Results: Fasting C-peptide (FCP) data at diagnosis were available in 3668 patients stratified according to age at diagnosis in four groups (<5years, n=344; >5years<10years, n=668; >10years<18years, n=991; >18years, n=1655). FCP levels were positively correlated with age (p<0.001); the subsequent decline in FCP over time was log-linear with a greater decline rate in younger age groups (p<0.0001). Conclusions: This study reveals a positive correlation between age at diagnosis of type 1 diabetes and FCP with a more rapid decline of β-cell function in the very young patients. These data can inform the design of clinical trials using C-peptide values as an end-point for the effect of a given treatment.

U2 - 10.1111/dom.12216

DO - 10.1111/dom.12216

M3 - Journal article

C2 - 24118704

SN - 1462-8902

VL - 16

SP - 262

EP - 267

JO - Diabetes, Obesity and Metabolism

JF - Diabetes, Obesity and Metabolism

IS - 3

ER -