Residual insulin secretion in long-standing type 1 diabetes

IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Petra Augstein, Natalie Buschmann, Janik Riese, Sabine Bochnig, Peter Heinke, Michael Schlosser, Wolfgang Kerner
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Abstract

Aims

Studies involving the use of sensitive C-peptide assays have revealed that a significant number of persons with long-standing type 1 diabetes have measurable serum C-peptide concentrations. We investigated meal-stimulated C-peptide levels in persons with diabetes duration of more than 30 years and whether they were associated with the presence of diabetes-associated autoantibodies.

Methods

This was an observational study of 105 participants with a clinical diagnosis of type 1 diabetes and a diabetes duration ≥30 years. Participants underwent mixed-meal tolerance tests (MMTTs) with measurements of C-peptide at 0 and 90 min. The levels of autoantibodies against GAD, IA-2 and ZnT8 were measured with radio-binding assays.

Results

Participants were divided into tertiles of post-meal (90 min) C-peptide values as non-responders (NR), low-responders (LR) and high-responders (HR). Compared with the NRs and HRs, the LRs had significantly lower BMI values (p < 0.001), plasma triglyceride concentrations (p = 0.010) and triglyceride/HDL-cholesterol ratios (p = 0.004). Twenty-nine and eight participants were positive for one or 2–3 antibodies, respectively. The presence of antibodies was not associated with post-meal C-peptide levels, as evidenced by the fact that the proportions of antibody-positive participants did not differ between the groups.

Conclusions

We conclude that a subgroup of type 1 diabetes participants with long-standing diabetes (>30 years) has residual beta-cell function. Participants with type 1 diabetes and low stimulated C-peptide concentrations are characterized by lower BMI, triglyceride concentrations and higher insulin sensitivity.

长期存在的1型糖尿病的残留胰岛素分泌。
目的:涉及使用敏感c肽测定的研究表明,大量长期患有1型糖尿病的患者血清c肽浓度可测量。我们调查了30年以上糖尿病患者饮食刺激的c肽水平,以及它们是否与糖尿病相关自身抗体的存在相关。方法:这是一项观察性研究,105名临床诊断为1型糖尿病且糖尿病病程≥30年的参与者。参与者在0和90分钟进行混合膳食耐受性测试(mmtt),测量c肽。用放射结合法测定抗GAD、IA-2和ZnT8的自身抗体水平。结果:参与者餐后(90分钟)c肽值被分为无反应者(NR)、低反应者(LR)和高反应者(HR)。与NRs和HRs相比,LRs的BMI值明显较低(p)。结论:我们得出的结论是,1型糖尿病患者中有一个亚组患有长期糖尿病(bb10 - 30年),存在剩余的β细胞功能。1型糖尿病和低刺激c肽浓度的参与者具有较低的BMI、甘油三酯浓度和较高的胰岛素敏感性。
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来源期刊
Diabetic Medicine
Diabetic Medicine 医学-内分泌学与代谢
CiteScore
7.20
自引率
5.70%
发文量
229
审稿时长
3-6 weeks
期刊介绍: Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
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