J Korean Med Sci.  2013 Sep;28(9):1340-1344. 10.3346/jkms.2013.28.9.1340.

The Clinical Measures Associated with C-peptide Decline in Patients with Type 1 Diabetes over 15 Years

• Lee TH
• Kwon AR
• Kim YJ
• Chae HW
• Kim HS
• Kim DH

• KMID: 1793050
• DOI: http://doi.org/10.3346/jkms.2013.28.9.1340

Abstract

This study was done to characterize the natural course of C-peptide levels in patients with type 1 diabetes and identify distinguishing characters among patients with lower rates of C-peptide decline. A sample of 95 children with type 1 diabetes was analyzed to retrospectively track serum levels of C-peptide, HbA1c, weight, BMI, and diabetic complications for the 15 yr after diagnosis. The clinical characteristics were compared between the patients with low and high C-peptide levels, respectively. The average C-peptide level among all patients was significantly reduced five years after diagnosis (P < 0.001). The incidence of diabetic ketoacidosis was significantly lower among the patients with high levels of C-peptide (P = 0.038). The body weight and BMI standard deviation scores (SDS) 15 yr after diagnosis were significantly higher among the patients with low C-peptide levels (weight SDS, P = 0.012; BMI SDS, P = 0.044). In conclusion, C-peptide level was significantly decreased after 5 yr from diagnosis. Type 1 diabetes patients whose beta-cell functions were preserved might have low incidence of diabetic ketoacidosis. The declines of C-peptide level after diagnosis in type 1 diabetes may be associated with changes of body weight and BMI.

Keyword

Diabetes Mellitus, Type 1; C-Peptide; Body Weight; Body Mass Index; Diabetic Ketoacidosis

MeSH Terms

Adolescent
Body Mass Index
Body Weight
C-Peptide/*blood
Child
Child, Preschool
Diabetes Complications
Diabetes Mellitus, Type 1/blood/*diagnosis
Diabetic Ketoacidosis/epidemiology
Diabetic Retinopathy/epidemiology
Female
Follow-Up Studies
Hemoglobin A, Glycosylated/analysis
Humans
Incidence
Infant
Male
Peripheral Nervous System Diseases/epidemiology
Retrospective Studies
C-Peptide
Hemoglobin A, Glycosylated

Figure

• 

  Fig. 1 Average fasting C-peptide levels of each of group A and B at the time of diagnosis and during serial follow-up over 15 yr. *P = 0.015 between groups A and B at the 15th year after diagnosis from a linear mixed model. Data are represented as mean ± SE. Black circle = group A, C-peptide level at 15th year < 0.05 nM/L; white circle = group B, C-peptide level at 15th year ≥ 0.05 nM/L.

• 

  Fig. 2 Average body weight and BMI during follow-up period. (A) Body weight SDS with time progression in each of the two groups. *P = 0.012 between groups A and B at the 15th year after diagnosis from a linear mixed model. (B) BMI SDS with time progression in each of the two groups. †P = 0.044 between group A and B at the 15th year after diagnosis from a linear mixed model. Data are represented as mean ± SE. Black circle = group A, C-peptide level at 15th year < 0.05 nM/L; white circle = group B, C-peptide level at 15th year ≥ 0.05 nM/L.

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