Characterization of residual β cell function in long‐standing type 1 diabetes
JL Sherr, T Ghazi, A Wurtz, L Rink… - … research and reviews, 2014 - Wiley Online Library
JL Sherr, T Ghazi, A Wurtz, L Rink, KC Herold
Diabetes/metabolism research and reviews, 2014•Wiley Online LibraryBackground Some patients with long‐standing type 1 diabetes (T1D) maintain detectable
levels of C‐peptide. The quantitative and qualitative aspects of insulin secretion in these
subjects have not been assessed, but may shed light on the basis for maintained β cell
function. Our objective was to characterize insulin secretion in subjects with varying duration
of T1D. Methods Data from mixed‐meal tolerance tests were collected in this cross‐sectional
study. We screened 58 subjects with T1D< 1 year and 34 subjects with T1D> 2 years, 20 of …
levels of C‐peptide. The quantitative and qualitative aspects of insulin secretion in these
subjects have not been assessed, but may shed light on the basis for maintained β cell
function. Our objective was to characterize insulin secretion in subjects with varying duration
of T1D. Methods Data from mixed‐meal tolerance tests were collected in this cross‐sectional
study. We screened 58 subjects with T1D< 1 year and 34 subjects with T1D> 2 years, 20 of …
Background
Some patients with long‐standing type 1 diabetes (T1D) maintain detectable levels of C‐peptide. The quantitative and qualitative aspects of insulin secretion in these subjects have not been assessed, but may shed light on the basis for maintained β cell function. Our objective was to characterize insulin secretion in subjects with varying duration of T1D.
Methods
Data from mixed‐meal tolerance tests were collected in this cross‐sectional study. We screened 58 subjects with T1D <1 year and 34 subjects with T1D >2 years, 20 of whom had previously participated in trials of anti‐CD3 monoclonal antibody. Data from 38 historical non‐diabetic controls were utilized. Insulin secretory rates were calculated from C‐peptide levels from mixed‐meal tolerance tests. Patterns and rates of insulin secretion were characterized along with relationships between insulin secretion and clinical parameters.
Results
C‐peptide was detected in 68% of subjects with T1D duration >2 years. Insulin secretion was negatively correlated with HgbA1c and insulin use. A decline in total insulin secretion was seen with increasing disease duration (p < 0.0001). More subjects with long duration of T1D had a delayed time to peak secretion compared with those with new onset T1D or non‐diabetic subjects. Insulin and glucagon secretory responses appeared unrelated.
Conclusions
Meal‐stimulated insulin secretory responses are seen in those with long‐standing T1D and detectable C‐peptide. Delayed insulin secretory responses are more common in individuals with longer disease duration. Residual insulin secretory responses are associated with improved clinical parameters. Copyright © 2013 John Wiley & Sons, Ltd.
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