Characterization of residual [beta] cell function in long-standing type 1 diabetes

• Published in: Diabetes/metabolism research and reviews 2014-02, Vol.30 (2), p.154
• Main Authors: Sherr, Jennifer L, Ghazi, Tara, Wurtz, Anna, Rink, Linda, Herold, Kevan C
• Format: Article
• Language: English
• ISSN: 1520-7552; 1520-7560
• DOI: 10.1002/dmrr.2478

Background Some patients with long-standing type 1 diabetes (T1D) maintain detectable levels of C-peptide. The quantitative and qualitative aspects of insulin secretion in these subjects have not been assessed, but may shed light on the basis for maintained [beta] cell function. Our objective was to characterize insulin secretion in subjects with varying duration of T1D. Methods Data from mixed-meal tolerance tests were collected in this cross-sectional study. We screened 58 subjects with T1D 2years, 20 of whom had previously participated in trials of anti-CD3 monoclonal antibody. Data from 38 historical non-diabetic controls were utilized. Insulin secretory rates were calculated from C-peptide levels from mixed-meal tolerance tests. Patterns and rates of insulin secretion were characterized along with relationships between insulin secretion and clinical parameters. Results C-peptide was detected in 68% of subjects with T1D duration >2years. Insulin secretion was negatively correlated with HgbA1c and insulin use. A decline in total insulin secretion was seen with increasing disease duration (p