Serial Dried Blood Spot C-Peptide Sampling, but Not Urine C-Peptide–to–Creatinine Ratio, Detects Early Preservation of β-Cell Function in New-Onset Type 1 Diabetes: Experience From the USTEKID Trial
Authors' conclusion
Frequently sampled glucose-adjusted DBS was more sensitive to early change than MMTT and could serve as a home-based marker of β-cell function, whereas UCPCR was not sensitive to change in the early period.
Study context
- Population
- Adolescents with recent-onset T1D in the USTEKID trial
- Comparison
- Urine C-peptide-to-creatinine ratio (UCPCR) and glucose-adjusted dried blood spot (DBS) C-peptide vs mixed-meal tolerance test (MMTT) C-peptide
- Primary endpoint
- Whether UCPCR and DBS C-peptide could replace MMTT C-peptide in an interventional trial
Primary result
As reported in the abstract
C-peptide by UCPCR, DBS and MMTT · 12 months
- Unlike MMTT C-peptide, UCPCR did not change in the first 6 months, then decreased by 12 months
- DBS AUC 0–60 min declined steadily over 12 months
- Intervention vs control difference not apparent with UCPCR; not evident until 52 weeks with MMTT
- Intervention vs Control: P < 0.05
Further findings
Prediction of 12-month MMTT C-peptide from 6-month DBS slope
- 6-month DBS slope predicted 12-month MMTT C-peptide in control but not in intervention group
Original publication
Serial Dried Blood Spot C-Peptide Sampling, but Not Urine C-Peptide–to–Creatinine Ratio, Detects Early Preservation of β-Cell Function in New-Onset Type 1 Diabetes: Experience From the USTEKID Trial. Diabetes Care. Published 12 May 2026. doi:10.
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