Age-dependent decline of β-cell function in type 1 diabetes after diagnosis: a multi-centre longitudinal study
Abstract
Aims: C‐peptide secretion is currently the only available clinical biomarker to measure residual β‐cell function in type 1 diabetes. However, the natural history of C‐peptide decline after diagnosis can vary considerably dependent upon several variables. We investigated the shape of C‐peptide decline over time from type 1 diabetes onset in relation to age at diagnosis, haemoglobin A1c ( HbA1c ) levels and insulin dose. Methods: We analysed data from 3929 type 1 diabetes patients recruited from seven European centres representing all age groups at disease onset (childhood, adolescence and adulthood). The influence of the age at onset on β‐cell function was investigated in a longitudinal analysis at diagnosis and up to 5‐years follow‐up. Results: Fasting C‐peptide (FCP) data at diagnosis were available in 3668 patients stratified according to age at diagnosis in four groups (<5 years, n = 344; >5 years < 10 years, n = 668; >10 years < 18 years, n = 991; >18 years, n = 1655). FCP levels were positively correlated with age (p < 0.001); the subsequent decline in FCP over time was log‐linear with a greater decline rate in younger age groups (p < 0.0001). Conclusions: This study reveals a positive correlation between age at diagnosis of type 1 diabetes and FCP with a more rapid decline of β‐cell function in the very young patients. These data can inform the design of clinical trials using C‐peptide values as an end‐point for the effect of a given treatment.
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The relationship between age at diagnosis and C-peptide levels may be explained by age at diagnosis reflecting the strength and intensity of the underlying autoimmune process.
“This may explain the relationship seen in our data and numerous other studies(3; 18; 19).”
From Most people with long-duration type 1 diabetes in a large population-based study are insulin microsecretors (2015) · cites this paper as [19]
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- Authors
- Barker, A., Lauria, A., Schloot, N., Hosszufalusi, N., Ludvigsson, J., Mathieu, C., Mauricio, D., Nordwall, M., Van der Schueren, B., Mandrup‐Poulsen, T., Scherbaum, W. A., Weets, I., Gorus, F. K., Wareham, N., Leslie, R. D., & Pozzilli, P.
- Affiliations
- MRC Epidemiology Unit (GB)
- Università Campus Bio-Medico (IT)
- Deutsches Diabetes-Zentrum e.V. (DE)
- 3rd Department of Internal Medicine Semmelweis University Budapest Hungary
- Linköping University (SE)
- KU Leuven (BE)
- Hospital Universitari Arnau de Vilanova (ES)
- Laboratory for Experimental Medicine and Endocrinology Katholieke Universiteit Leuven Leuven Belgium
- Department of Biomedical Sciences University of Copenhagen Copenhagen Denmark
- Heinrich Heine University Düsseldorf (DE)
- Vrije Universiteit Brussel (BE)
- Queen Mary University of London (GB)
- ORCID
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2013-10-29
- Volume
- 16
- Issue
- 3
- Pages
- 262-267
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W1998995830
- Cited by
- 101
- References
- 40
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 8 · 2023: 7 · 2022: 13 · 2021: 9 · 2020: 6 · 2019: 9 · 2018: 9 · 2017: 9 · 2016: 7 · 2015: 8 · 2014: 4
- FWCI
- 4.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Obesity and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0512-10135)
- Medical Research Council (MC_UU_12015/1)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- type 1 diabetes, beta-cell function, C-peptide, age at diagnosis, residual beta-cell function, fasting C-peptide, HbA1c, insulin dose, natural history of disease, clinical trial endpoints
- MeSH terms
- Adolescent, Adult, Age Factors, Aging, C-Peptide, Child, Child, Preschool, Diabetes Mellitus, Type 1, Dose-Response Relationship, Drug, Europe, Fasting, Female, Follow-Up Studies, Humans, Hypoglycemic Agents, Insulin, Insulin Antibodies, Longitudinal Studies, Male, Biomarkers, Age of Onset, Insulin-Secreting Cells
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