Preservation of β-cell function in autoantibody-positive youth with diabetes
Open accessAbstract
OBJECTIVE: To determine the extent of β-cell function in youth with diabetes and GAD65 and/or IA2 autoantibodies. RESEARCH DESIGN AND METHODS: Fasting C-peptide levels from 2,789 GAD65- and/or IA2 autoantibody-positive youth aged 1–23 years from the SEARCH for Diabetes in Youth study were used. Preserved β-cell function was defined on the basis of cut points derived from the Diabetes Control and Complications Trial (DCCT) (fasting C-peptide ≥0.23 ng/ml) and from the U.S. adolescent population of the National Health and Nutrition Examination Survey (NHANES) 5th percentile for fasting C-peptide (≥1.0 ng/ml). We compared the clinical characteristics between those with and without preserved β-cell function. RESULTS: Within the first year of diagnosis, 82.9% of youth had a fasting C-peptide ≥0.23 ng/ml and 31.2% had values ≥1.0 ng/ml. Among those with ≥5 years of diabetes duration, 10.7% had preserved β-cell function based on the DCCT cutoff and 1.0% were above the 5th percentile of the NHANES population. CONCLUSIONS: Within the 1st year of diagnosis, four of five youth with autoantibody-positive diabetes have clinically significant amounts of residual β-cell function and about one-third have fasting C-peptide levels above the 5th percentile of a healthy adolescent population. Even 5 years after diagnosis, 1 of 10 has fasting C-peptide above a clinically significant threshold. These findings have implications for clinical classification of youth with diabetes as well as clinical trials aimed to preserve β-cell function after diabetes onset.
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At diagnosis, people with type 1 diabetes have reduced β-cell function compared with healthy controls.
“At diagnosis, people with type 1 diabetes have reduced β-cell function compared with healthy controls.61”
From Type 1 diabetes (2018) · cites this paper as [61]
The Results (page unavailable) show that among autoantibody-positive youth studied within one year of diagnosis, 31.2% had fasting C-peptide at or above the healthy-adolescent 5th percentile, supporting generally lower β-cell function relative to that reference population. The study does not measure function precisely at diagnosis, and its findings in youth do not establish the claim for all people with type 1 diabetes. (LLM, conf=0.85)
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- Authors
- Greenbaum, C. J., Anderson, A. M., Dolan, L. M., Mayer-Davis, E. J., Dabelea, D., Imperatore, G., Marcovina, S., Pihoker, C., & for the SEARCH Study Group
- Affiliations
- Virginia Mason Medical Center (US)
- Wake Forest University Health Sciences (US)
- Cincinnati Children's Hospital Medical Center (US)
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina and the Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina;
- Colorado School of Public Health (US)
- Centers for Disease Control and Prevention (US)
- University of Washington (US)
- Corresponding author
- Greenbaum, Carla J.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-07-08
- Volume
- 32
- Issue
- 10
- Pages
- 1839-1844
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2752937
- OpenAlex
- W2119813462
- Cited by
- 90
- References
- 25
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 2 · 2022: 5 · 2021: 13 · 2020: 2 · 2019: 2 · 2018: 8 · 2017: 4 · 2016: 3 · 2015: 7 · 2014: 6 · 2013: 4 · 2012: 13
- FWCI
- 4.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (M01RR008084, M01RR001271, M01 RR00069, M01 RR-01070, M01RR001070, M01-RR 00037, M01RR000069, M01RR000037, M01-RR-08084)
- National Center for Chronic Disease Prevention and Health Promotion (U01 DP-000247, U01-DP000246, U01-DP-000250, U01-DP-000254, U01DP000245, U01 DP000248, U01DP000244)
- 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
- beta-cell function, type 1 diabetes, youth, GAD65 antibodies, fasting C-peptide, residual beta-cell function, SEARCH for Diabetes in Youth, diabetes classification, diabetes duration
- MeSH terms
- Adolescent, Autoantibodies, C-Peptide, Child, Child, Preschool, Diabetes Mellitus, Female, Humans, Infant, Male, Insulin-Secreting Cells, Young Adult
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