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首页> 外文期刊>Diabetes care >C-Peptide Levels in Subjects Followed Longitudinally Before and After Type 1 Diabetes Diagnosis in TrialNet
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C-Peptide Levels in Subjects Followed Longitudinally Before and After Type 1 Diabetes Diagnosis in TrialNet

机译：受试者中的C-肽水平遵循TAWENT中1型糖尿病诊断前后的纵向和之后

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OBJECTIVE Insulin secretion declines rapidly after diagnosis of type 1 diabetes, followed by a slower rate of change. Previous studies have demonstrated that the C-peptide decline begins before the clinical diagnosis. Changes in insulin secretion in the same individuals studied from preclinical stages through and after clinical diagnosis have not been previously reported. RESEARCH DESIGN AND METHODS Antibody-positive relatives undergo sequential oral glucose tolerance testing (OGTT) as part of TrialNet's Pathway to Prevention study and continue both OGTT and mixed-meal tolerance testing (MMTT) as part of the Long-term Investigational Follow-up in TrialNet study if they develop type 1 diabetes. We analyzed glucose and C-peptide data obtained from 80 TrialNet subjects who had OGTT before and after clinical diagnosis. Separately, we compared C-peptide response to OGTT and MMTT in 127 participants after diagnosis. RESULTS C-peptide did not change significantly until 6 months before the clinical diagnosis of type 1 diabetes and continued to decline postdiagnosis, and the rates of decline for the first 6 months postdiagnosis were similar to the 6 months prediagnosis. There were no significant differences in MMTT and OGTT C-peptide responses in paired tests postdiagnosis. CONCLUSIONS This is the first analysis of C-peptide levels in longitudinally monitored patients with type 1 diabetes studied from before diagnosis and continuing to the postdiagnosis period. These data highlight the discordant timing between accelerated beta-cell dysfunction and the current glucose thresholds for clinical diagnosis. To preserve beta-cell function, disease-modifying therapy should start at or before the acute decline in C-peptide.
机译：客观胰岛素分泌后诊断1型糖尿病后迅速下降，随后发生较慢的变化率。以前的研究表明，在临床诊断之前，C-肽下降开始。先前，尚未报道临床诊断后从临床前阶段研究的同一个体中胰岛素分泌的变化。研究设计和方法抗体阳性亲属接受连续口腔葡萄糖耐量检测（OGTT）作为预防研究的一部分，并继续作为长期调查后续行动的一部分的OGTT和混合膳食公差测试（MMTT）如果他们开发1型糖尿病，则自动培训学习。我们分析了从临床诊断前后具有OGTT的80名试验型受试者获得的葡萄糖和C-肽数据。另外，我们将C-肽反应与诊断后127名参与者的OGTT和MMTT进行了比较。结果C-肽在1型糖尿病临床诊断前6个月并未发生显着变化，并且持续下降衰竭，并且前期衰竭的前6个月下降的率类似于6个月的预诊断。 MMTT和OGTT C-肽反应没有显着差异，对后诊断的配对试验。结论这是第一次分析纵向监测患者患者患者1型糖尿病患者的C-肽水平分析，并在诊断之前研究，并继续诊断到后诊断期。这些数据突出了加速β细胞功能障碍与临床诊断的当前葡萄糖阈值之间的不安全时机。为了保持β细胞功能，疾病改性治疗应该在C-肽的急性下降之前或之前开始。

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