Residual insulin secretion in individuals with type 1 diabetes in Finland: longitudinal and cross-sectional analyses
Authors' conclusion
Although children with multiple autoantibodies and HLA risk genotypes progressed to absolute insulin deficiency rapidly, many adolescents and adults had residual random serum C-peptide decades after the diagnosis. Polygenic risk of type 1 and type 2 diabetes affected residual random serum C-peptide. Even low residual random serum C-peptide concentrations seemed to be associated with a beneficial complications profile.
Study context
- Population
- Individuals with T1D in Finland: newly diagnosed at Helsinki University Hospital (longitudinal); FinnDiane participants from 57 centres (diagnosed after 5 years of age, insulin within 1 year, C-peptide <1.0 nmol/L) and DIREVA patients (cross-sectional)
- Exposure
- Residual random serum C-peptide vs no random serum C-peptide
- Residual C-peptiden = 776
- Outcome
- Residual random serum C-peptide secretion (>0.02 nmol/L), FinnDiane
- Follow-up
- Median duration 21.6 years (IQR 12.5-31.2)
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Residual C-peptide
19.4%
776
- Residual C-peptide associated with lower T1D polygenic risk vs no C-peptide
- P < 0.0001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Microvascular complications by random serum C-peptideResidual C-peptidevs No C-peptide | adjusted OR, nephropathy 0.61 (95% CI 0.38–0.96) | P = 0.033 | |
| Microvascular complications by random serum C-peptideResidual C-peptidevs No C-peptide | adjusted OR, retinopathy 0.55 (95% CI 0.34–0.89) | P = 0.014 | |
| 0.20.5125Ratio (log scale) |
Microvascular complications by random serum C-peptide
- Random serum C-peptide inversely associated with hypertension, HbA1c and cholesterol
C-peptide decline (longitudinal)
- Age at diagnosis strongly correlated with decline in C-peptide secretion
- 847 participants <16 years and 110 aged ≥16 years
Original publication
Residual insulin secretion in individuals with type 1 diabetes in Finland: longitudinal and cross-sectional analyses. Lancet Diabetes Endocrinol. Published 5 June 2023. doi:10.
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