Characterization of residual β cell function in long‐standing type 1 diabetes. Issue 2 (February 2014)

• Record Type: Journal Article
• Authors: Sherr, Jennifer L.; Ghazi, Tara; Wurtz, Anna; Rink, Linda; Herold, Kevan C.
• Is Part Of: Diabetes/metabolism research and reviews. Volume 30:Issue 2(2014:Feb.)
• Page Start: 154
• Page End: 162
• Publication Date: 2014-02
• Subjects: Diabetes -- Periodicals; Metabolism -- Periodicals; 616.642
• DOI: 10.1002/dmrr.2478
• Languages: English
• ISSNs: 1520-7552

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="dmrr2478-sec-0001" sec-type="section"> <title>Background</title> <p>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 <italic>β</italic> cell function. Our objective was to characterize insulin secretion in subjects with varying duration of T1D.</p> </sec> <sec id="dmrr2478-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="dmrr2478-sec-0003" sec-type="section"> <title>Results</title> <p>C‐peptide was detected in 68% of subjects with T1D duration >2 years. Insulin secretion was negatively correlated with HgbA<sub>1c</sub> and insulin use. A decline in total insulin secretion was seen with increasing disease duration (<italic>p</italic> < 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.</p> </sec> <sec id="dmrr2478-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>