期刊
JOURNAL OF CLINICAL INVESTIGATION
卷 131, 期 3, 页码 -出版社
AMER SOC CLINICAL INVESTIGATION INC
DOI: 10.1172/JCI143011
关键词
-
资金
- Division of Diabetes, Endocrinology, and Metabolic Diseases of the NIDDK [U01 DK094176, U01 DK094157]
- National Eye Institute
- National Institute of Neurologic Disorders and Stroke
- General Clinical Research Centers Program (1993-2007)
- Clinical Translational Science Center Program, Bethesda, Maryland, USA (2006)
- NIH through the NIDDK grant [1-DP3-DK104438]
- NIH
The study found that long-term type 1 diabetes mellitus patients may still have residual beta cell function, which is associated with a reduced prevalence of severe hypoglycemia.
BACKGROUND. We investigated residual beta cell function in Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study participants with an average 35-year duration of type 1 diabetes mellitus (T1DM). METHODS. Serum C-peptide was measured during a 4-hour mixed-meal tolerance test. Associations with metabolic outcomes and complications were explored among nonresponders (all C-peptide values after meal <0.003 nmol/L) and 3 categories of responders, classified by peak C-peptide concentration (nmol/L) as high (>0.2), intermediate (>0.03 to <= 0.2), and low (>= 0.003 to <= 0.03). RESULTS. Of the 944 participants, 117 (12.4%) were classified as responders. Residual C-peptide concentrations were associated with higher DCCT baseline concentrations of stimulated C-peptide (P value for trend = 0.0001). Residual C-peptide secretion was not associated with current or mean HbA1c, HLA high-risk haplotypes for T1DM, or the current presence of T1DM autoantibodies. The proportion of subjects with a history of severe hypoglycemia was lower with high (27%) and intermediate (48%) residual C-peptide concentrations than with low (74%) and no (70%) residual C-peptide concentrations (P value for trend = 0.0001). Responders and nonresponders demonstrated similar rates of advanced microvascular complications. CONCLUSION. beta Cell function can persist in long-duration T1DM. With a peak C-peptide concentration of >0.03 nmol/L, we observed clinically meaningful reductions in the prevalence of severe hypoglycemia.
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