Preservation of C-peptide after diagnosis of type 1 diabetes (T1D) is associated with lower risk of both hypoglycemia and long-term microvascular complications. The decline of C-peptide after T1D onset is highly variable among subjects. The goal of this study was to evaluate factors associated with the rate of C-peptide decline. TEDDY participants identified at birth with high-risk HLA genotype and followed regularly until T1D diagnosis (n=70) and 60 age-matched children diagnosed with T1D in the community (median age at diagnosis = 6.7 years, IQR 5.1-7.9) were enrolled in a 2-year follow-up with mixed meal tolerance tests at 1, 3, 6, 12 and 24 months. Mixed effects models for repeated measures were used adjusting for age at diagnosis and C-peptide at baseline. In univariate analyses, factors associated with rate of C-peptide loss included sex, age at diagnosis, baseline BMI, AUC C-peptide, HbA1c, IA-2A positivity and ZnT8A positivity. Four of these 7 factors remained significant in multivariate analysis (all p ≤ 0.037, see Table). Younger age at diagnosis, higher HbA1c, IA-2A positivity and ZnT8A positivity were associated with higher rate of C-peptide decline in this young cohort of children diagnosed with T1D.
A. Steck: None. X. Liu: None. J. Krischer: None. M.J. Haller: Advisory Panel; Self; Pancreum, SAB Biotherapeutics. R. Veijola: None. B. Akolkar: None. J. Toppari: None. W. Hagopian: Research Support; Self; Novo Nordisk A/S. M. Rewers: None. H. Elding Larsson: None.
JDRF; National Institutes of Health