Trends of Earlier and Later Responses of C-peptide to Oral Glucose Challenges With Progression to Type 1 Diabetes in Diabetes Prevention Trial–Type 1 Participants
Open accessAbstract
OBJECTIVE: We studied the C-peptide response to oral glucose with progression to type 1 diabetes in Diabetes Prevention Trial–Type 1 (DPT-1) participants. RESEARCH DESIGN AND METHODS: Among 504 DPT-1 participants <15 years of age, longitudinal analyses were performed in 36 progressors and 80 nonprogressors. Progressors had oral glucose tolerance tests (OGTTs) at baseline and every 6 months from 2.0 to 0.5 years before diagnosis; nonprogressors had OGTTs over similar intervals before their last visit. Sixty-six progressors and 192 nonprogressors were also studied proximal to and at diagnosis. RESULTS: The 30–0 min C-peptide difference from OGTTs performed 2.0 years before diagnosis in progressors was lower than the 30–0 min C-peptide difference from OGTTs performed 2.0 years before the last visit in nonprogressors (P < 0.01) and remained lower over time. The 90–60 min C-peptide difference was positive at every OGTT before diagnosis in progressors, whereas it was negative at every OGTT before the last visit in nonprogressors (P < 0.01 at 2.0 years). The percentage whose peak C-peptide occurred at 120 min was higher in progressors at 2.0 years (P < 0.05); this persisted over time (P < 0.001 at 0.5 years). However, the peak C-peptide levels were only significantly lower at 0.5 years in progressors (P < 0.01). The timing of the peak C-peptide predicted type 1 diabetes (P < 0.001); peak C-peptide levels were less predictive (P < 0.05). CONCLUSIONS: A decreased early C-peptide response to oral glucose and an increased later response occur at least 2 years before the diagnosis of type 1 diabetes.
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Metabolic changes in the natural history of type 1 diabetes are marked by decreased early C-peptide response at least 2 years before onset, increased glucose fluctuations as an individual approaches onset, and an overall linear rise, with a last-minute surge, in plasma glucose in the months before onset.
“Metabolic changes in the natural history of type 1 diabetes are marked by decreased early C-peptide response at least 2 years before onset,80 increased glucose fluctuations as an individual approaches onset,81 and an overall linear rise, with a last-minute surge, in plasma glucose in”
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- Authors
- Sosenko, J. M., Palmer, J. P., Rafkin, L. E., Krischer, J. P., Cuthbertson, D., Greenbaum, C. J., Eisenbarth, G., Skyler, J. S., & Diabetes Prevention Trial–Type 1 Study Group
- Affiliations
- University of Miami (US)
- University of Washington (US)
- University of South Florida (US)
- Benaroya Research Institute (US)
- HLA/DNA Laboratory, University of Colorado, Aurora, Colorado.
- Corresponding author
- Sosenko, Jay M.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-12-23
- Volume
- 33
- Issue
- 3
- Pages
- 620-625
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2827520
- OpenAlex
- W2164825249
- Cited by
- 62
- References
- 14
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 11 · 2021: 4 · 2020: 7 · 2019: 3 · 2018: 3 · 2017: 6 · 2016: 5 · 2015: 1 · 2014: 4 · 2013: 3 · 2012: 4
- FWCI
- 1.56
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- CERN
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK061034, UC4DK117009)
- 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, C-peptide response, oral glucose tolerance test, prediabetes, disease progression, early biomarkers, insulin secretion
- MeSH terms
- Adolescent, C-Peptide, Child, Diabetes Mellitus, Type 1, Female, Glucose, Glucose Tolerance Test, Humans, Longitudinal Studies, Male, Prediabetic State, Time Factors, Cohort Studies, Disease Progression, Area Under Curve
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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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