Tapering decay of β‐cell function in Chinese patients with autoimmune type 1 diabetes: A four‐year prospective study

Abstract

Background This study investigated the natural progression of β‐cell function in Chinese autoimmune type 1 diabetic (T1D) patients and clarified factors possibly influencing the course of the disease. Methods The natural progression of β‐cell function of 325 newly diagnosed Chinese autoimmune T1D patients was assessed by fasting and postprandial C‐peptide (FCP and PCP, respectively) levels. β‐Cell function failure was defined as FCP <50 pM and PCP <100 pM, whereas preserved β‐cell function was defined as FCP >200 pM or PCP >400 pM. β‐Cell function that did not meet these criteria was described as residual. Results At initial recruitment, 33.3% of patients had β‐cell function failure, whereas 41.0% and 25.8% of patients had preserved or residual β‐cell function, respectively. The percentage of patients who developed β‐cell function failure during follow‐up at 12, 24, 36, and 48 months after recruitment to the study was 55.8%, 75.6%, 86.7%, and 92.7%, respectively. Moreover, the slope of the β‐cell function curve decreased over time, indicating that the pattern of its decline was non‐linear and tapering. Seven percent of patients did not develop β‐cell function failure within 4 years after diagnosis. Patients with lower initial FCP levels were more likely to develop β‐cell function failure. Conclusions Chinese autoimmune T1D patients have considerable residual β‐cell function at initial diagnosis, and the manner of progression of β‐cell function failure is non‐linear with a tapering decay rate. Furthermore, initial FCP levels may predict β‐cell function failure in Chinese autoimmune T1D patients.

Impact of flash glucose monitoring on glycemic control varies with the age and residual β‐cell function of patients with type 1 diabetes mellitus

“…With respect to beta-cell function evaluation, FCP and 2hCP are frequently used in clinical practice due to their good consistency with MMTT or glucagon stimulated C-P [33][34][35][36] and the ability to predict beta-cell function in autoimmune T1DM 37,38 . In the landmark Diabetes Control and Complications Trial (DCCT) study, the role of beta-cell function was first demonstrated in T1DM patients using intensive insulin therapy 39 .…”

The continuous spectrum of glycaemic variability changes with pancreatic islet function: A multicentre cross‐sectional study in China

“…after MMTT are commonly used indicators to assess pancreatic β-cell function. 34,35 The role of β-cell function in T1D patients treated with intensive insulin therapy was initially demonstrated in the DCCT. 36 Patients with CP between 200 and 500 pmol/L after MMTT had lower HbA1c levels, daily insulin dosage, and incidence of severe hypoglycaemia.…”

“…2hCP following MMTT stimulation can reflect endogenous insulin secretion since MMTT comprises carbohydrates, fats, and proteins that promote insulin secretion under near‐physiological settings. Thus, FCP and 2hCP after MMTT are commonly used indicators to assess pancreatic β ‐cell function 34,35 . The role of β ‐cell function in T1D patients treated with intensive insulin therapy was initially demonstrated in the DCCT 36 .…”

Association of RPS26 gene polymorphism with different types of diabetes in Chinese individuals

“…Islet β‐cell function was assessed using fasting C‐peptide (FCP) and 2‐h postprandial C‐peptide (PCP) values. For autoimmune type 1 diabetes mellitus, FCP ≥200 pmol/L or PCP ≥400 pmol/L showed preserved β‐cell function 30 . The FCP cutoff value of ≥200 pmol/L was also applied to define adequate β‐cell function in previous studies of type 2 diabetes mellitus 31 .…”