期刊
DIABETOLOGIA
卷 53, 期 1, 页码 36-44出版社
SPRINGER
DOI: 10.1007/s00125-009-1569-3
关键词
Beta cell function; C-peptide; Hyperglycaemic clamp test; IA-2 antibodies; Insulin; Prediction; Prevention; Type 1 diabetes
资金
- Juvenile Diabetes Research Foundation [4-20051327]
- Belgian Fund for Scientific Research [G. 0319.01, G. 0517.04, G. 0311.07]
- Brussels Free University-VUB [OZR1150, OZR1449]
- Willy Gepts fund (University Hospital Brussels)
- Novo Nordisk Pharma nv
- Belgian National Lottery
- Ministries of Public Health of the Flemish and French Communities of Belgium
- Weightwatchers
- Ortho-Clinical Diagnostics, Novo Nordisk Pharma, Lifescan, Roche Diagnostics, Bayer and Eli Lilly
The aim of the study was to investigate the use of hyperglycaemic clamp tests to identify individuals who will develop diabetes among insulinoma-associated protein-2 antibody (IA-2A)-positive first-degree relatives (IA-2A(+) FDRs) of type 1 diabetic patients. Hyperglycaemic clamps were performed in 17 non-diabetic IA-2A(+) FDRs aged 14 to 33 years and in 21 matched healthy volunteers (HVs). Insulin and C-peptide responses were measured during the first (5-10 min) and second (120-150 min) release phase, and after glucagon injection (150-160 min). Clamp-induced C-peptide release was compared with C-peptide release during OGTT. Seven (41%) FDRs developed diabetes 3-63 months after their initial clamp test. In all phases they had lower C-peptide responses than non-progressors (p < 0.05) and HVs (p < 0.002). All five FDRs with low first-phase release also had low second-phase release and developed diabetes 3-21 months later. Two of seven FDRs with normal first-phase but low second-phase release developed diabetes after 34 and 63 months, respectively. None of the five FDRs with normal C-peptide responses in all test phases has developed diabetes so far (follow-up 56 to 99 months). OGTT-induced C-peptide release also tended to be lower in progressors than in non-progressors or HVs, but there was less overlap in results between progressors and the other groups using the clamp. Clamp-derived functional variables stratify risk of diabetes in IA-2A(+) FDRs and may more consistently identify progressors than OGTT-derived variables. A low first-phase C-peptide response specifically predicts impending diabetes while a low second-phase response may reflect an earlier disease stage. ClinicalTrials.gov NCT00654121 The insulin trial was financially supported by Novo Nordisk Pharma nv.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据