RT Journal Article
SR Electronic
T1 Factors Predicting Course of β-cell Function in IDDM
JF Diabetes Care
JO Diabetes Care
FD American Diabetes Association
SP 997
OP 1001
DO 10.2337/diacare.15.8.997
VO 15
IS 8
A1 Schiffrin, Alicia
A1 Suissa, Samy
A1 Weitzner, Gabriel
A1 Poussier, Philippe
A1 Lalla, Daniel
YR 1992
UL http://care.diabetesjournals.org/content/15/8/997.abstract
AB OBJECTIVE The purpose of this study was to determine whether the severity o clinical presentation, sex, age, HLA type, and the presence of IAs and ICAs could predict the variation of residual insulin secretion as measured by the serum C-peptide response to a Sustacal meal. RESEARCH DESIGN AND METHODS A cohort of 151 newly diagnosed IDDM children (mean age 10.2 ± 4.6 yr) was followed prospectively for 3 yr. Thirty-five patients (12 males, 23 females) were still secreting C-peptide after 36 mo. RESULTS We found that age (P = 0.0001), sex (P = 0.003), presence of ICA (P = 0.006), severity of clinical presentation (P = 0.001), and symptom duration (P = 0.002) significantly predicted the rate of loss of C-peptide secretion. The risks of accelerated C-peptide disappearance decreased with increasing age, the risk ratios being 0.25 for the older group (> 12 yr) compared with the younger group (< 6 yr) and 0.50 for the intermediate group (6–12 yr) compared with the younger group. The risk for the presence of ICA was 1.7, and the risk for males was 1.7 also. There was a significant negative correlation between ICA titers and C-peptide at 18 and 24 mo after diagnosis (P = 0.04). There were no significant differences in HbA1 values between patients who secreted C-peptide and those who did not. CONCLUSIONS We conclude that younger age of onset, male sex, high titers of ICA, severe clinical presentation, and shorter symptom duration significantly predict accelerated rates of loss of C-peptide secretion.