Chonnam Med J.  2017 Sep;53(3):216-222. 10.4068/cmj.2017.53.3.216.

Factors Associated with C-peptide Levels after Diagnosis in Children with Type 1 Diabetes Mellitus

• Hwang JW
• Kim MS
• Lee DY

• KMID: 2390436
• DOI: http://doi.org/10.4068/cmj.2017.53.3.216

Abstract

C-peptide is the best indicator of endogenous insulin secretion in patients with diabetes. This study investigated the relationship between C-peptide levels and clinical/laboratory parameters of children with type 1 diabetes mellitus (T1DM), as measured at 6-month intervals after diagnosis. We retrospectively reviewed the data of 34 children with newly diagnosed T1DM. The study subjects were subdivided into a rapid progression group with C-peptide levels <0.6 ng/mL at 36 months (n=27; Group A) and a slow progression group with C-peptide levels >0.6 ng/mL at 36 months (n=7; Group B). Patients in Group A had a younger mean age at diagnosis (A: 9±4.3 years vs. B: 13.6±3.6 years; p=0.013) and lower body mass index (BMI) (A: 15.5±2.5 kg/m² vs. B: 18.7±3.3 kg/m²; p=0.035). There were fewer asymptomatic patients with glucosuria in Group A, with these patients showing more severe symptoms, such as diabetic ketoacidosis (p=0.035), than those in Group B. Group A also had lower initial C-peptide levels (A: 0.5±0.46 ng/mL vs. B: 1.87±1.08 ng/mL; p=0.001). There were no significant intergroup differences in sex, family history, baseline hemoglobin A1c (HbA1c), potential of hydrogen (pH), autoantibodies or serum insulin. Simple correlation analyses showed that C-peptide levels were correlated with age and BMI, but not with pH, insulin, or HbA1c. Younger patients, who had a lower BMI, significant symptoms with complications, and/or a low initial C-peptide level, tended to show a rapid rate of decrease in C-peptide levels. Early intensive insulin therapy to preserve beta-cell function should be considered in these groups.

Keyword

Body Mass Index; C-peptide; Diabetes Mellitus, Type 1

MeSH Terms

Autoantibodies
Body Mass Index
C-Peptide*
Child*
Diabetes Mellitus, Type 1*
Diabetic Ketoacidosis
Diagnosis*
Humans
Hydrogen
Hydrogen-Ion Concentration
Insulin
Retrospective Studies
Autoantibodies
C-Peptide
Hydrogen
Insulin

Figure

• 

  FIG. 1 C-peptide levels at diagnosis of type 1 diabetes mellitus in both groups. Group A (Rapid progression group): C-peptide <0.6 ng/mL at 36 months, Group B (Slow progression group): C-peptide ≥0.6 ng/mL at 36 months.

• 

  FIG. 2 Distributions of follow-up C-peptide levels over 36 months. Group A (Rapid progression group): C-peptide <0.6 ng/mL at 36 months, Group B (Slow progression group): C-peptide ≥0.6 ng/mL at 36 months.

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