Background: type I diabetes is associated with progressive destruction of pancreatic β-cells with gradual decline of insulin secretion. C-peptide is considered the best indicator of endogenous insulin secretion in patients with diabetes.
Aim of the Work: evaluate the effect of different variables associated with preserved pancreatic beta cell function at one year after diagnosis of children with type I DM.
Patients and Methods: the study is cohort study comprising 93 newly diagnosed type I diabetic children (46 females and 47 males) with age ranging from 3.25 to 16 years. They were divided into 2 groups: preserved pancreatic functions (stimulated c-peptide [S-CP] ≥0.6ng/ml), non-preserved pancreatic function (S-CP <0.6ng/ml). Mixed meal stimulated C-peptide and glycated hemoglobin was assessed at time of diagnosis and after 12 months of follow up during regular visits at outpatient clinic. The variables assessed were age at diagnosis, gender, residence, Z-score of weight, height, body mass index (BMI), family history of type I DM, season at diagnosis, presence of DKA at diagnosis, glycated hemoglobin (HbA1c), insulin regimen and total daily insulin dose.
Results: preserved pancreatic function was associated significantly with older age (P = 0.04), colder months (winter and autumn) (P = 0.03) and higher glycated hemoglobin levels at diagnosis (P = 0.04). Residence, gender, body weight, height, BMI, presence of DKA at diagnosis, total insulin dose and insulin regimen failed to predict preserved C-peptide levels at 12 months follow up.
Conclusion: Older age, colder seasons and initially higher glycated hemoglobin at diagnosis remains significantly associated with preserved C-peptide after 12 months follow up.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology