Work

Residual C-peptide is associated with new and persistent impaired awareness of hypoglycaemia in type 1 diabetes

Year: 2024

Type: article

Abstract: To describe the change in impaired awareness of hypoglycaemia (IAH) over time and to identify factors associated with this change in the Dutch Type 1 Diabetes biomarkers cohort ( NCT04977635 ). A prospective cohort of type 1 diabetes patients, with C-peptide <300 pmol/L, who had completed the Clarke questionnaire, to determine IAH status, at baseline and after 2 years. Changes in awareness status were defined and compares as follows: unchanged normal awareness (NAH) versus unchanged IAH, new IAH versus reversal of IAH. Multivariate logistic regression models were fitted using forward and backward stepwise selection using a 0.10 P -value cut-off, and stepwise backward selection using AIC criteria. A total of 431 out of 611 participants were included. The baseline prevalence of IAH was 17 % and 20 % after 2 years. The incidence proportion of new IAH and reversal of IAH were, 9.5 % and 31 %, respectively. For every 2.7-fold increase in C-peptide, the odds of IAH decrease by 58 %. A 1-unit increase in BMI over the 2-year follow-up period is associated with a 5.27-fold increase in the odds of reversing IAH. Higher C-peptide levels are protective against new IAH, and an increase in BMI over time is associated with the reversal of IAH. • Impaired awareness of hypoglycaemia (IAH) is a complication of insulin therapy that raises the risk of hypoglycaemic events. • Lower c-peptide and higherdiastolic blood pressure were independently associated with new IAH. • An increase in BMI over time was associated with reversal of IAH.

Source: Journal of Diabetes and its Complications

DOI: 10.1016/j.jdiacomp.2024.108893

Authors: R.D.M. Varkevisser, T. Sas, H.J. Aanstoot, B.H.R. Wolffenbuttel, M.M. van der Klauw

Institutions: University Medical Center Groningen, University of Groningen, Erasmus MC - Sophia Children’s Hospital

Language: English

Topic: Diabetes Management and Research

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,220