Background: C-peptide secretion is the most accurate measurement of residual β-cell function in type 1 diabetes (T1D) and even residual levels seem to positively correlate with a lower probability of complications.
Objective and hypotheses: Identify key determinants to the evolution of the β pancreatic cell function, measured by fasting C-peptide (FCP).
Method: Prospective study of patients diagnosed with T1D, with evaluation of the FCP at diagnosis and after 12 months of follow-up. The FCP evolution was correlated with age at diagnosis (group 1: ≧5 years; group 2: 610 years and group 3: ≧11 years), autoimmunity, hemoglobin A1c (HbA1c) and presence of ketoacidosis at diagnosis. SPSS 22 was used for data analysis.
Results: 20 patients were included, with equal gender distribution. At diagnosis, the median age was 8 years old and 25% had ketoacidosis. The mean value of FCP was 0.53 ng/ml at diagnosis and 0.51 ng/ml after 12 months of follow-up. Group 1 showed a FCP mean decrease of 0.31 ng/ml, while those in group 3 showed a mean increase of 0.49 ng/ml (P<0.05). Group 2 maintained a similar value with a decrease of 0.05 ng/ml. At 12 months of follow-up, the mean HbA1c in group 1 was 7.4%, 7.2% in group 2 and 6.7% in group 3. The patients with a HbA1c ≤7.5 showed a better residual β-cell function (P<0.05) and less insulin requirements (P<0.05). There was no association between FCP variation and autoimmunity, gender and ketoacidosis at diagnosis.
Conclusion: The FCP level variation was positively correlated with age. The group of patients with ≤5 years had a worse metabolic control and a more pronounced loss of pancreatic reserve, translated by the declining value of C-Peptide.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology