ESPE Abstracts (2015) 84 P-3-746

Residual C-Peptide in Paediatric Patients with Type 1 Diabetes

Maria Martin-Frias, Yoko P Oyakawa, Milagros Alonso, Belen Roldan, M Angeles Alvarez & Raquel Barrio

Ramon y Cajal Hospital, Madrid, Spain

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: 1–16.7 years in undetectable and 1–11.8 years in detectable C-peptide subgroup. Only 3/24 patients with >10 years T1D evolution had detectable C-peptide (10.0–11.7 years evolution, C-peptide 0.01–0.09 ng/ml); 5/27 patients with <2 years T1D evolution had undetectable C-peptide (1.0–1.6 years evolution, age diagnosis 5.1 years (0.6–10.9)). HbA1c was lower in detectable C-peptide subgroup but not significantly. C-peptide levels were negatively correlated with diabetes evolution and HbA1c levels.

Table 1 (for abstract P3-746)
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)
P 0.188 0.855 0.927 0.004 <0.001 0.001

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.

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