ESPE2024 Poster Category 1 Diabetes and Insulin 4 (8 abstracts)
Higher levels of c-peptide at the onset of Type 1 Diabetes are correlated with better glycemic control after 2 years from the diagnosis in a cohort of pediatric patients.
Marco Marigliano , Claudia Piona , Valentina Mancioppi , Elisa Morotti , Elena Fornari , Francesca Olivieri , Anita Morandi & Claudio Maffeis
Section of Pediatric Diabetes and Metabolism, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy
Background and Objective: Diabetic ketoacidosis (DKA) is an acute endocrinological emergency in childhood. It occurs in 20-40% of cases at the onset of Type 1 Diabetes (T1D). DKA is classified as mild, moderate, and severe based on the clinical picture and blood pH levels. This study aims to evaluate the relationship between the characteristics of T1D onset (DKA level, pH, c-peptide) and the glycometabolic control 2, 5, and 10 years after the diagnosis.
Subjects and Methods: Data from 408 children and adolescents with T1D were analyzed. The characteristics at T1D onset (presence of DKA, DKA severity, pH, HCO3-, c-peptide level, socio-economic characteristics) and glycometabolic control [(HbA1c, glucometrics form glycaemic sensor (CGM)] at 2, 5, and 10 years were analyzed.
Results: At T1D onset, 38.5% of the subjects had DKA (14.5% mild DKA, 9.3% moderate and 9.8% severe). There was a statistically significant correlation between the c-peptide values at T1D onset and CGM glucometrics after 2 years from the diagnosis (T2) but not after 5 (T5) and 10 (T10) years. A positive correlation was found between the c-peptide level at the onset and time spent in the glycaemic target (TIR 70-180 mg/dl r:0.196, P <0.01), negative correlation with time spent in hypoglycaemia (TBR <54 mg/dl r: -0.194, P <0.02 and TBR 54-70 mg/dl r:-0.199, P <0.02) and glycaemic variability (CV: r: -0.180, P <0.05 and GRI: r:-0.196, P <0.02).
Conclusion: A higher c-peptide level at the onset of T1D is correlated with better glucose control after two years (more TIR, less time in hypoglycemia, lower glucose variability). This effect is lost after five and ten years from the onset of T1D.
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