A Glucose Fraction Independent of Insulin Secretion: Implications for Type 1 Diabetes Progression in Autoantibody-Positive Cohorts
Authors' conclusion
A glucose fraction independent of insulin secretion was identified that was appreciable in autoantibody-positive individuals. It provides insight into the relation between glucose and C-peptide, contributes substantially to the glycemia of IGT, and predicts both T1D and IGT, particularly the latter.
Study context
- Population
- Autoantibody-positive individuals with baseline 2-h OGTT data from TrialNet Pathway to Prevention (TNPTP) and Diabetes Prevention Trial-Type 1 (DPT-1)TNPTP n = 6190
- Comparison
- Glucose fraction independent of insulin secretion vs dependent fraction
Methodological detailsLinear regression of AUC glucose vs Index60 to identify fractions dependent or independent of insulin secretion
- Linear regression of AUC glucose vs Index60 to identify fractions dependent or independent of insulin secretion
Primary result
As reported in the abstract
Correlation of glucose fractions with insulin secretion · baseline
- Correlation of iAUCGLU with first-phase insulin response (DPT-1)
- r = 0.06
- Correlation of dAUCGLU with first-phase insulin response (DPT-1)
- r = −0.59
- Correlation of AUC C-peptide with dAUCGLU, TNPTP
- r = −0.72
- Correlation of AUC C-peptide with iAUCGLU, TNPTP
- r = 0.57
- Correlation of AUC C-peptide with dAUCGLU, DPT-1
- r = −0.56
- Correlation of AUC C-peptide with iAUCGLU, DPT-1
- r = 0.60
- Explained variance of AUC C-peptide after separating AUC glucose into fractions, TNPTP
- from 4% to 85%
- Explained variance of AUC C-peptide after separating AUC glucose into fractions, DPT-1
- from 1% to 67%
Further findings
Contribution to glycemia of impaired glucose tolerance (IGT)
- The independent fraction contributed more to the increased glycemia of IGT than the dependent fraction
Prediction of IGT and T1D
- Both dAUCGLU and iAUCGLU predicted IGT and T1D
- P < 0.0001 for all
- Prediction of T1D, chi-square dAUCGLU vs iAUCGLU
- 849 vs. 249
- Prediction of IGT, chi-square iAUCGLU vs dAUCGLU
- 451 vs. 176
Original publication
A Glucose Fraction Independent of Insulin Secretion: Implications for Type 1 Diabetes Progression in Autoantibody-Positive Cohorts. Diabetes Technol Ther. Published 6 January 2025. doi:10.
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