Random C-Peptide and Islet Antibodies at Onset Predict β Cell Function Trajectory and Insulin Dependence in Pediatric Diabetes
Authors' conclusion
C-peptide and islet autoimmunity at diagnosis define distinct phenotypes and predict beta-cell function and insulin dependence 6 to 12 months later in racially/ethnically diverse children with new-onset diabetes.
Study context
- Population
- Children with new-onset diabetes; 50% male, 76.4% White, 20.8% Black, 46.5% Hispanic; median age 12.4 (8.3–14.5) yearsmedian follow-up 8 months
- Participants
- 72 children
- Exposure
- Aβ subgroups by islet autoantibody status and random serum C-peptide at diagnosis
- A+β-n = 46
- A-β-n = 1
- A+β+n = 4
- A-β+n = 21
- Outcome
- Beta-cell function (2 h postprandial/stimulated UCPCR) and clinical outcomes incl. insulin dependence
- Follow-up
- 6 to 12 months after diagnosis (V2)
Main finding
As reported in the abstract
UCPCR, HbA1c and insulin independence by Aβ subgroup · V2 (6 to 12 months)
| Group | Value | Insulin-independent |
|---|---|---|
| A-β+ | 38% | 38% |
| A+β- | 0 events | 0 |
| A-β- | 0 events | 0 |
| A+β+ | 0 events | 0 |
Value
A-β+38%
A+β-0 events
A-β-0 events
A+β+0 events
Insulin-independent
A-β+38%
A+β-0
A-β-0
A+β+0
- A-β+: P < 0.001
- β- subgroups had lower urinary C-peptide-to-creatinine ratio (UCPCR) than β+ subgroups
- P < 0.001
- β- subgroups had higher HbA1c than β+ subgroups
- P = 0.02
Observational data: associations, not effects.
Further findings
Correlation of baseline serum C-peptide with UCPCR
- Correlation at V1
- r = 0.36, P = .002
- Correlation at V2
- r = 0.47, P < .001
Baseline subgroup differences
- Significant subgroup differences in age, race, DKA frequency and T1D genetic risk score
- P < 0.01
Original publication
Random C-Peptide and Islet Antibodies at Onset Predict β Cell Function Trajectory and Insulin Dependence in Pediatric Diabetes. Endocr Pract. Published 3 October 2024. doi:10.
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