Preservation of β-Cell Function in Autoantibody-Positive Youth With Diabetes
Published Date:Jul 08 2009
Source:Diabetes Care. 32(10):1839-1844.
Corporate Authors:for the SEARCH Study Group*
Pubmed Central ID:PMC2752937
Funding:M01 RR00069/RR/NCRR NIH HHS/United States
M01 RR01070/RR/NCRR NIH HHS/United States
M01 RR08084/RR/NCRR NIH HHS/United States
M01RR00037/RR/NCRR NIH HHS/United States
M01RR001271/RR/NCRR NIH HHS/United States
U01 DP000244/DP/NCCDPHP CDC HHS/United States
U01 DP000245/DP/NCCDPHP CDC HHS/United States
U01 DP000246/DP/NCCDPHP CDC HHS/United States
U01 DP000247/DP/NCCDPHP CDC HHS/United States
U01 DP000248/DP/NCCDPHP CDC HHS/United States
U01 DP000250/DP/NCCDPHP CDC HHS/United States
U01 DP000254/DP/NCCDPHP CDC HHS/United States
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.
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.
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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