Factors Associated with C-Peptide Levels during the First 3 Years after Diagnosis in Children with Type 1 Diabetes Mellitus

Presentation Number: LB SUN 75
Date of Presentation: April 2nd, 2017

Iee ho Choi*1, Jung Won Hwang2, Min Sun sun Kim3 and Dae-Yeol Lee4
1Department of Pediatrics, Chonbuk National University Medical School, Jeonju 561-712, Korea, Korea, Republic of (South), 2Chonbuk National University Hospital, Jeonju, Korea, Republic of (South), 3Department of Pediatrics, Chonbuk National University Medical School, Jeonju 561-712, Korea, 4Department of Pediatrics, Chonbuk National University Medical School, Jeonju 561-712, Korea, Jeonju, Korea, Republic of (South)

Abstract

Objective: C-peptide is the best measurement of endogenous insulin secretion in patients with diabetes. This study investigated the relationship between C-peptide level and clinical/laboratory parameters of children with type 1 diabetes mellitus (T1DM), measured at 6-month intervals for the first 3 years after diagnosis.

Methods: We retrospectively reviewed the data of 34 children with newly diagnosed T1DM. The study subjects were subdivided in the rapid progression group with a C-peptide level <0.6 ng/mL at 36 months (n=27; Group A) and the slow progression group with a C-peptide level >0.6 ng/mL at 36 months (n=7; Group B).

Results: Patients in Group A had a younger mean age at diagnosis (A: 8.7±4.3 years vs. B: 13.6±3.6 years; p=0.009), lower BMI (A: 16.25±2.48 kg/m2 vs. B: 18.65±3.32 kg/m2; p=0.041), and more severe symptoms (p=0.013) than those in Group B. Patients in Group A also had a lower initial pH (A: 7.31±0.15 vs. B: 7.40±0.03; p=0.014) and initial C-peptide level (A: 0.64±0.46 ng/mL vs. B: 0.87±1.08 ng/mL; p=0.022). There were no significant intergroup differences in sex, family history, or baseline hemoglobin A1c (HbA1c), pancreatic autoantibodies, or serum insulin. Simple correlation analyses showed that C-peptide levels were correlated with age and BMI but not with pH, insulin, or HbA1c. However, in Group B patients, C-peptide level at diagnosis was correlated with HbA1c (γ=0.046, p=-0.756).

Conclusion: Patients with a younger age, a lower BMI, significant symptoms, and a low initial C-peptide level require early intensive insulin therapy to preserve beta-cell function.

 

 

Nothing to Disclose: IHC, JWH, MSSK, DYL