The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.
β-Cell Function and the Development of Diabetes-Related Complications in the Diabetes Control and Complications Trial
Open accessAbstract
In patients with type 1 diabetes, measurement of connecting peptide (C-peptide), cosecreted with insulin from the islets of Langerhans, permits estimation of remaining β-cell secretion of insulin. In this retrospective analysis to distinguish the incremental benefits of residual β-cell activity in type 1 diabetes, stimulated (90 min following ingestion of a mixed meal) C-peptide levels at entry in the Diabetes Control and Complications Trial (DCCT) were related to measures of diabetic retinopathy and nephropathy and to incidents of severe hypoglycemia. Based on the analytical sensitivity of the assay (0.03 nmol/l) and study entry criteria, the DCCT subjects were divided into four groups of stimulated C-peptide responses: ≤0.03, 0.04–0.20, 0.21–0.50 nmol/l at entry, and 0.21–0.50 nmol/l at entry and at least 1 year later (sustained C-peptide secretion). Uniformly in the intensive and partially in the conventional DCCT treatment groups, any C-peptide secretion, but especially at higher and sustained levels of stimulated C-peptide, was associated with reduced incidences of retinopathy (both a single three-step change and a repeated three-step change on the Early Treatment of Diabetic Retinopathy Study [ETDRS] scale at the next 6 month visit) and nephropathy (both albuminuria >40 mg/24 h once and repeated at the next annual visit). There were also differences in severe hypoglycemia across C-peptide levels in both treatment groups. In the intensively treated cohort there were essentially identical prevalences of severe hypoglycemia (∼65% of participants) in the first three groups; however, those subjects with mixed-meal stimulated C-peptide level >0.20 nmol/l for at least baseline and the first annual visit in the DCCT experienced a reduced prevalence of ∼30%. Therefore, even modest levels of β-cell activity at entry in the DCCT were associated with reduced incidences of retinopathy and nephropathy. Also, continuing C-peptide (insulin) secretion is important in avoiding hypoglycemia (the major complication of intensive diabetic therapy).
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Although this endogenous secretion is typically low, maintenance is important since it is associated with less retinopathy and less severe hypoglycaemia at later stages of the disease.86”
From Type 1 diabetes (2014) · cites this paper as [86]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“natural history studies, intervention trials, and transplantation studies consistently show that higher Cpeptide responses to a mixed meal are associated with improved glycaemic control, fewer hypoglycaemic episodes, and reduced longterm complications.[55][56][57]”
From The future of type 1 diabetes therapy (2025) · cites this paper as [57]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“This finding is noteworthy because in the Diabetes Control and Complications Trial68,69 persistent C-peptide secretion was associated with reduced development of retinopathy, nephropathy, and hypoglycaemia.”
From Type 1 diabetes (2018) · cites this paper as [69]
In the citing paper
“In addition, we analysed two other thresholds: UCPCR≥0.03 nmol/mmol and ≥0.2nmol/mmol, which are equivalent to serum C peptide of 30 pmol/L (a common historical limit of detection(3; 11; 12)) and 200 pmol/L (a clinically defined level associated with reduced microvascular complications and hypoglycaemia(13)).”
From Most people with long-duration type 1 diabetes in a large population-based study are insulin microsecretors (2015) · cites this paper as [11]
In the citing paper
“The strongest evidence to date, however, finds that while higher and sustained levels of C-peptide are most beneficial, even modest levels of β-cell function in some with long-term disease are associated with lower rates of hypoglycemia and lower incidence of retinopathy and nephropathy (9,11).”
From Persistence of prolonged C-peptide production in type 1 diabetes as measured with an ultrasensitive C-peptide assay (2012) · cites this paper as [11]
In the citing paper
“The strongest evidence to date, however, finds that while higher and sustained levels of C-peptide are most beneficial, even modest levels of β-cell function in some with long-term disease are associated with lower rates of hypoglycemia and lower incidence of retinopathy and nephropathy (9,11).”
From Persistence of prolonged C-peptide production in type 1 diabetes as measured with an ultrasensitive C-peptide assay (2012) · cites this paper as [11]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
(1993) · New England Journal of Medicine · doi:10.1056/nejm199309303291401 · Cited by 24,667
Statistical Methods in Cancer Research. Volume II – The Design and Analysis of Cohort Studies
Juul, S. (1989) · Scandinavian Journal of Social Medicine · doi:10.1177/140349488901700214 · Cited by 3,602
The design and analysis of cohort studies
Breslow, N. E., & Day, N. E. (1987) · International Agency for Research on Cancer eBooks · Cited by 1,312
The Diabetes Control and Complications (DCCT) Research Group (1995) · Kidney International · doi:10.1038/ki.1995.236 · Cited by 694
Gerich, J. E., Langlois, M., Noacco, C., Karam, J. H., & Forsham, P. H. (1973) · Science · doi:10.1126/science.182.4108.171 · Cited by 688
(1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-7-199804010-00001 · Cited by 546
The DCCT Research Group (1986) · Diabetes · doi:10.2337/diabetes.35.5.530 · Cited by 466
(1995) · Archives of Ophthalmology · doi:10.1001/archopht.1995.01100010038019 · Cited by 325
Hypoglycemia: The Limiting Factor in the Management of IDDM
Cryer, P. E. (1994) · Diabetes · doi:10.2337/diab.43.11.1378 · Cited by 307
THE DCCT RESEARCH GROUP (1987) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-65-1-30 · Cited by 215
Cited by
Sorted by citations
Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2014) · The Lancet · doi:10.1016/s0140-6736(13)60591-7 · Cited by 2,931
DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. (2018) · The Lancet · doi:10.1016/s0140-6736(18)31320-5 · Cited by 1,561
Clinical Practice Guidelines for Multiple Endocrine Neoplasia Type 1 (MEN1)
Thakker, R. V., Newey, P. J., Walls, G. V., Bilezikian, J. P., Dralle, H., Ebeling, P. R., Melmed, S. K., Sakurai, A., Tonelli, F., & Brandi, M. L. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-1230 · Cited by 1,500
Cryer, P. E., Axelrod, L., Grossman, A. B., Heller, S. R., Montori, V. M., Seaquist, E. R., & Service, F. J. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-1410 · Cited by 1,277
Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer
Francis, G. L., Waguespack, S. G., Bauer, A. J., Angelos, P., Benvenga, S., Cerutti, J. M., Dinauer, C., Hamilton, J. K., HAY, I. D., Luster, M., et al. (2015) · Thyroid · doi:10.1089/thy.2014.0460 · Cited by 1,273
Metadata
- Authors
- Steffes, M. W., Sibley, S., Jackson, M., & Thomas, W.
- Affiliations
- University of Minnesota (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2003-03-01
- Volume
- 26
- Issue
- 3
- Pages
- 832-836
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W1988519907
- Cited by
- 695
- References
- 25
- Citations by year
- 2026: 20 · 2025: 26 · 2024: 30 · 2023: 34 · 2022: 39 · 2021: 49 · 2020: 38 · 2019: 29 · 2018: 31 · 2017: 32 · 2016: 30 · 2015: 44 · 2014: 32 · 2013: 53 · 2012: 37
- FWCI
- 8.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (M01RR000400, M01-RR00400)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Keywords
- type 1 diabetes, residual beta-cell function, C-peptide, diabetic retinopathy, diabetic nephropathy, albuminuria, severe hypoglycemia, intensive insulin therapy, diabetes complications, Diabetes Control and Complications Trial
- MeSH terms
- Adult, Blood Glucose, C-Peptide, Diabetes Mellitus, Type 1, Diabetic Nephropathies, Diabetic Retinopathy, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Islets of Langerhans, Male, Retrospective Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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 ›
Are you an author, or do you see a problem with this page? Request a review
