Background: Preservation of C-peptide is important and has become regarded a relevant endpoint as already a quite small residual C-peptide seems to be related to both less acute and late diabetes complications.
Objective: To assess the residual C-peptide secretion in pediatric patient with T1D.
Method: Cross-sectional study of 157 patients with T1D. We analyzed: age at diagnosis, age at time of study (years), sex, diabetes duration (years, ≥1 year of T1D), HbA1c (HPLC-Menarini, mean 6 last months), and fasting C-peptide levels (chemiluminescent immunoassay, minimum detectable 0.01 ng/ml). Data reported in percentage, mean±S.D.; C-peptide levels in median and range. Statistical analysis was performed with SPSS 17.0.
Results: 58% patients had undetectable C-peptide; in this subgroup duration of T1D was significantly longer, with younger, but not significantly, age at diagnosis. Minimum and maximum diabetes evolution: 116.7 years in undetectable and 111.8 years in detectable C-peptide subgroup. Only 3/24 patients with >10 years T1D evolution had detectable C-peptide (10.011.7 years evolution, C-peptide 0.010.09 ng/ml); 5/27 patients with <2 years T1D evolution had undetectable C-peptide (1.01.6 years evolution, age diagnosis 5.1 years (0.610.9)). HbA1c was lower in detectable C-peptide subgroup but not significantly. C-peptide levels were negatively correlated with diabetes evolution and HbA1c levels.
|C-peptide||n (%)||Age debut (years)||HbA1c (%)||Age study (years)||T1D evolution||C-peptide levels (ng/ml)|
|Years||<5 years||>10 years|
|Global||157 (100%)||6.5±4.0||6.8±0.7||12.2±4.6||5.6±3.8||83 (53%)||24 (15%)|||
|Undetectable||91 (58%)||5.1±3.4||6.9±0.8||12.4±4.6||7.2±3.8||31 (37%)||21 (88%)|||
|Detectable||66 (42%)||8.5±3.9||6.6±0.7||11.9±4.6||3.3±2.6||52 (63%)||3 (12%)||0.14 (0.01-1.4)|
Conclusion: The natural course of T1D in paediatric age is heterogeneous. Lower C-peptide levels are associated with longer duration of diabetes and earlier age at diagnosis.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology