Mixed‐meal tolerance test to assess residual beta‐cell secretion: Beyond the area‐under‐curve of plasma C‐peptide concentration
Year: 2019
Type: article
Study design: Observational Study
Abstract: Aims Residual beta-cell secretion in type 1 diabetes is commonly assessed by area-under-curve of plasma C-peptide concentration (AUCCpep) following mixed-meal tolerance test (MMTT). We aimed to investigate alternative measures of beta-cell responsiveness. Methods We analyzed data from 32 youth (age 7 to 17 years) undergoing MMTT within 6 months of type 1 diabetes diagnosis. We related AUCCpep with (a) validated mechanistic index of postprandial beta-cell responsiveness MI accounting for glucose level during MMTT, and (b) pragmatic marker calculated as baseline plasma C-peptide concentration corrected for baseline plasma glucose concentration. Results Postprandial responsiveness MI was correlated with age and BMI SDS (Rs = 0.66 and 0.44, P < 0.01 and P < 0.05) and was more correlated with glycated hemoglobin than AUCCpep (Rs = 0.79, P = 0.04). The pragmatic marker was highly correlated with AUCCpep (Rs = 0.94, P < 0.01). Conclusions Postprandial responsiveness MI may be more relevant to glucose control than AUCCpep. Baseline C-peptide corrected for baseline glucose appears to be a suitable surrogate of AUCCpep if MMTT is not performed.
Source: Pediatric Diabetes
DOI: 10.1111/pedi.12816
Language: English
Subfield: Genetics
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $4,300
Funders: Eli Lilly and Company, Leona M. and Harry B. Helmsley Charitable Trust, Juvenile Diabetes Research Foundation United Kingdom, Wellcome Trust, European Federation of Pharmaceutical Industries and Associations, National Institute for Health and Care Research, Novo Nordisk UK Research Foundation, Cambridge University Hospitals, Novo Nordisk, Innovative Medicines Initiative, Horizon 2020 Framework Programme, Efficacy and Mechanism Evaluation Programme, NIHR Cambridge Biomedical Research Centre, NIHR Evaluation Trials and Studies Coordinating Centre
Awards: G1681451205, G2018687014, G2522818804, G3308788765, G461391184, Institute of Metabolic Science., G4903748289, Diabetes and Inflammation Laboratory., G5246447471, G560916241, G6268769018, NIHR Senior Investigator Award, G6525891988, Institute of Metabolic Science., Diabetes and Inflammation Laboratory., G7696965656, G8007434194, G8312218698, Effect of closed loop insulin delivery from onset of diabetes in youth on progression of type 1 diabetes, G8585681489, G8589133502, G9000255165
OpenAlex ID: W2910403924