A1 Journal article – refereed

Factors Associated with Decline of C-peptide in a Cohort of Young Children Diagnosed with Type 1 Diabetes




List of Authors: Steck Andrea K, Liu Xiang, Krischer Jeffrey P, Haller Michael J, Veijola Riitta, Lundgren Markus, Ahmed Simi, Akolkar Beena, Toppari Jorma, Hagopian William A, Rewers Marian J, Elding Larsson Helena

Publisher: Oxford University Press

Publication year: 2021

Journal: Journal of Clinical Endocrinology and Metabolism

Volume number: 106

Issue number: 3

eISSN: 1945-7197

DOI: http://dx.doi.org/10.1210/clinem/dgaa715


Abstract

Context: Understanding factors involved in the rate of C-peptide decline is needed to tailor therapies for type 1 diabetes (T1D).

Objective: Evaluate factors associated with rate of C-peptide decline after T1D diagnosis in young children.

Design: Observational study.

Setting: Academic centers.

Participants: 57 participants in The Environmental Determinants of Diabetes in the Young (TEDDY) enrolled at 3 months of age and followed until T1D and 56 age-matched children diagnosed with T1D in the community.

Intervention: A mixed meal tolerance test was used to measure the area under the curve (AUC) C-peptide at 1, 3, 6, 12 and 24 months post-diagnosis.

Outcome: Factors associated with rate of C-peptide decline during the first 2 years post-diagnosis were evaluated using mixed effects models adjusting for age at diagnosis and baseline C-peptide.

Results: Adjusted slopes of AUC C-peptide decline did not differ between TEDDY subjects and community controls (p=0.21), although the former had higher C-peptide baseline levels. In univariate analyses combining both groups (n=113), younger age, higher weight and BMI z-scores, female sex, increased number of islet autoantibodies, and IA-2A or ZnT8A positivity at baseline were associated with higher rate of C-peptide loss. Younger age, female sex and higher weight z-score remained significant in multivariate analysis (all p<0.02). At three months after diagnosis, higher HbA1c became an additional independent factor associated with higher rate of C-peptide decline (p<0.01).

Conclusion: Younger age at diagnosis, female sex, higher weight z-score, and HbA1c were associated with higher rate of C-peptide decline after T1D diagnosis in young children.


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Last updated on 2021-15-10 at 13:21