Residual beta-cell function in diabetes children followed and diagnosed in the TEDDY study compared to community controls: STECK et al .
Open accessAbstract
OBJECTIVE: To explore whether children diagnosed with type 1 diabetes during islet autoantibody surveillance through The Environmental Determinants of Diabetes in the Young (TEDDY) study retain greater islet function than children diagnosed through the community. METHODS: TEDDY children identified at birth with high-risk human leukocyte antigen and followed every 3 months until diabetes diagnosis were compared to age-matched children diagnosed with diabetes in the community. Both participated in long-term follow up after diagnosis. Hemoglobin A1c (HbA1c) and mixed meal tolerance test were performed within 1 month of diabetes onset, then at 3, 6, and 12 months, and biannually thereafter. RESULTS: Comparison of 43 TEDDY and 43 paired control children showed that TEDDY children often had no symptoms (58%) at diagnosis and none had diabetic ketoacidosis (DKA) compared with 98% with diabetes symptoms and 14% DKA in the controls (P < 0.001 and P = 0.03, respectively). At diagnosis, mean HbA1c was lower in TEDDY (6.8%, 51 mmol/mol) than control (10.5%, 91 mmol/mol) children (P < 0.0001). TEDDY children had significantly higher area under the curve and peak C-peptide values than the community controls throughout the first year postdiagnosis. Total insulin dose and insulin dose-adjusted A1c were lower throughout the first year postdiagnosis for TEDDY compared with control children. CONCLUSIONS: Higher C-peptide levels in TEDDY vs community-diagnosed children persist for at least 12 months following diabetes onset and appear to represent a shift in the disease process of about 6 months. Symptom-free diagnosis, reduction of DKA, and the potential for immune intervention with increased baseline C-peptide may portend additional long-term benefits of early diagnosis.
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High-risk individuals identified within such protocols are less likely to present in DKA.
“However, high-risk individuals identified within such protocols are less likely to present in DKA (430).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [430]
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Sacks, D. B., Arnold, M., Bakris, G. L., Bruns, D. E., Horvath, A. R., Lernmark, Å., Metzger, B. E., Nathan, D. M., & Kirkman, M. S. (2023) · Diabetes Care · doi:10.2337/dci23-0036 · Cited by 351 · see citing works
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- Authors
- Steck, A. K., Larsson, H. E., Liu, X., Veijola, R., Toppari, J., Hagopian, W. A., Haller, M. J., Ahmed, S., Akolkar, B., Lernmark, Å., Rewers, M. J., Krischer, J. P., & and the TEDDY Study Group
- Affiliations
- University of Colorado Anschutz (US)
- Lund University (SE)
- University of South Florida (US)
- Oulu University Hospital (FI)
- University of Turku (FI)
- Pacific Northwest Research Institute (US)
- University of Florida Health (US)
- Breakthrough T1D (US)
- National Institutes of Health (US)
- Corresponding author
- Steck, Andrea K.
- ORCID
- Venue
- Pediatric Diabetes
- Publisher
- Wiley
- Published
- 2017-01-27
- Volume
- 18
- Issue
- 8
- Pages
- 794-802
- ISSN
- 1399-543X (ISSN-L)
- PMC
- PMC5529265
- OpenAlex
- W2581645967
- Semantic Scholar
- cc7be9754e87aad19295f5d71b8215ab248729aa
- Cited by
- 56
- References
- 39
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 7 · 2023: 10 · 2022: 5 · 2021: 7 · 2020: 2 · 2019: 5 · 2018: 7 · 2017: 1
- FWCI
- 2.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Pediatric Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Site cant be reached (submittedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (U01 DK63829, U01 DK63861, U01 DK63821, U01 DK63863, U01 DK63790, UC4 DK63829, UC4 DK63861, UC4 DK63821, UC4 DK63863, UC4 DK95300, HHSN267200700014C)
- National Institute of Allergy and Infectious Diseases
- National Institute of Child Health and Human Development
- National Institute of Environmental Health Sciences
- Centers for Disease Control and Prevention
- University of Florida (UL1 TR000064)
- University of Colorado (UL1 TR001082)
- Juvenile Diabetes Research Foundation (17-2011-274)
- 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, residual beta-cell function, C-peptide, TEDDY study, early diagnosis, mixed meal tolerance test, HbA1c, diabetic ketoacidosis, insulin dose
- MeSH terms
- C-Peptide, Child, Child, Preschool, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemic Agents, Insulin, Male, Population Surveillance, Prospective Studies, Case-Control Studies, Insulin-Secreting Cells
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