Heterogeneity in clinically diagnosed type 1 diabetes: characterising a unique cohort with maintained C-peptide secretion in Ghana
Authors' conclusion
Maintained C-peptide levels in two-thirds of individuals with long-term type 1 diabetes in Ghana, combined with the absence of autoantibodies and HLA risk association, highlight the necessity for better differentiation from atypical diabetes presentations to optimise patient care and improve health outcomes in resource-limited settings.
Study context
- Population
- Individuals in Ghana with clinically diagnosed, insulin-treated long-term T1D and healthy controls266 T1D, 266 controls
- Comparison
- Clinically diagnosed T1D classified by random C-peptide (low, mid, high) vs healthy controls
- Controln = 266reference
- Outcome
- Distribution of random C-peptide levels in clinically diagnosed T1D
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Clinical, genetic and autoimmune features
- Low C-peptide: youngest and leanest, higher frequencies of HLA class II risk haplotypes and GAD and ZnT8 autoantibodies vs all other groups
- Mid and high C-peptide resembled controls: low autoantibody titres and one protective HLA class II haplotype
- Ketosis at onset most prevalent with high C-peptide
Inflammatory and metabolic serum profiles
- Proinflammatory biomarkers differed between diabetes and controls, but not between C-peptide subgroups
- Aromatic and branched-chain amino acids varied between diabetes subgroups and positively correlated with C-peptide
Original publication
Heterogeneity in clinically diagnosed type 1 diabetes: characterising a unique cohort with maintained C-peptide secretion in Ghana. Diabetologia. Published 1 November 2025. doi:10.
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