PMID- 33987348
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220423
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 9
IP  - 8
DP  - 2021 Apr
TI  - Residual beta-cell function after 10 years of autoimmune type 1 diabetes: 
      prevalence, possible determinants, and implications for metabolism.
PG  - 650
LID - 10.21037/atm-20-7471 [doi]
LID - 650
AB  - BACKGROUND: Type 1 diabetes (T1D) has long been considered a progressive 
      autoimmune disease resulting in the failure of pancreatic beta-cell function and 
      absolute endogenous insulin deficiency. However, several studies have 
      demonstrated patients with T1D have detectable C-peptide levels long after 
      diagnosis, which has remarkable clinical significance. Since this issue has not 
      been systematically explored in non-Caucasian populations, we aimed to identify 
      the prevalence of residual beta-cell function and its related clinical features in 
      Chinese long-term T1D patients. METHODS: We enrolled 109 patients with T1D for 
      >/=10 years and administered a mixed-meal tolerance test (MMTT). Fasting and 
      postprandial C-peptide (FCP/PCP) levels were measured to evaluate the insulin 
      secretion function of beta-cells. Patients whose FCP and PCP levels were both below 
      the lower detection limit (16.7 pmol/L) were grouped as 'beta-cell function 
      depleted', while others were thought to have 'residual beta-cell function'. 
      Demographic data, metabolic status, and diabetic complications were compared 
      between patients with or without residual beta-cell function. RESULTS: 38.5% of 
      subjects retained residual beta-cell function, and among those, 33.3% responded to 
      MMTT by a two-fold or greater rise of their FCP levels. Clinical features 
      associated with residual beta-cell function were older age of diagnosis [27.5 
      (interquartile range:11.5-37.0) vs. 17.0 (interquartile range: 8.0-30.0) years, 
      P=0.037], lower HbA1c (64.6+/-20.3 vs. 72.4+/-18.5 mmol/mol, P=0.026), and reduced 
      rate of hypoglycemia (23.8% vs. 52.2%, P=0.003). Age of diagnosis was positively 
      correlated with detectable FCP level (r=0.393, P=0.020). Individuals diagnosed 
      after 30 years of age tended to retain residual beta-cell function (OR =3.016, 
      P=0.044). We found no association between residual beta-cell function and chronic 
      diabetic complications. CONCLUSIONS: Residual beta-cell function can be found in 
      nearly 40% of long-term patients with T1D in China and is associated with older 
      age at diagnosis and better glucose control. The relationship between residual 
      beta-cell function and chronic diabetic complications remains to be explored.
CI  - 2021 Annals of Translational Medicine. All rights reserved.
FAU - Cheng, Jin
AU  - Cheng J
AD  - National Clinical Research Center for Metabolic Disease, Key Laboratory of 
      Diabetes Immunology, Ministry of Education, Department of Metabolism and 
      Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 
      China.
FAU - Yin, Min
AU  - Yin M
AD  - National Clinical Research Center for Metabolic Disease, Key Laboratory of 
      Diabetes Immunology, Ministry of Education, Department of Metabolism and 
      Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 
      China.
FAU - Tang, Xiaohan
AU  - Tang X
AD  - National Clinical Research Center for Metabolic Disease, Key Laboratory of 
      Diabetes Immunology, Ministry of Education, Department of Metabolism and 
      Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 
      China.
FAU - Yan, Xiang
AU  - Yan X
AD  - National Clinical Research Center for Metabolic Disease, Key Laboratory of 
      Diabetes Immunology, Ministry of Education, Department of Metabolism and 
      Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 
      China.
FAU - Xie, Yuting
AU  - Xie Y
AD  - National Clinical Research Center for Metabolic Disease, Key Laboratory of 
      Diabetes Immunology, Ministry of Education, Department of Metabolism and 
      Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 
      China.
FAU - He, Binbin
AU  - He B
AD  - National Clinical Research Center for Metabolic Disease, Key Laboratory of 
      Diabetes Immunology, Ministry of Education, Department of Metabolism and 
      Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 
      China.
FAU - Li, Xia
AU  - Li X
AD  - National Clinical Research Center for Metabolic Disease, Key Laboratory of 
      Diabetes Immunology, Ministry of Education, Department of Metabolism and 
      Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 
      China.
FAU - Zhou, Zhiguang
AU  - Zhou Z
AD  - National Clinical Research Center for Metabolic Disease, Key Laboratory of 
      Diabetes Immunology, Ministry of Education, Department of Metabolism and 
      Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 
      China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC8106063
OTO - NOTNLM
OT  - C-peptide
OT  - Type 1 diabetes (T1D)
OT  - beta-cell function
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at http://dx.doi.org/10.21037/atm-20-7471). The authors have no 
      conflicts of interest to declare.
EDAT- 2021/05/15 06:00
MHDA- 2021/05/15 06:01
PMCR- 2021/04/01
CRDT- 2021/05/14 07:03
PHST- 2021/05/14 07:03 [entrez]
PHST- 2021/05/15 06:00 [pubmed]
PHST- 2021/05/15 06:01 [medline]
PHST- 2021/04/01 00:00 [pmc-release]
AID - atm-09-08-650 [pii]
AID - 10.21037/atm-20-7471 [doi]
PST - ppublish
SO  - Ann Transl Med. 2021 Apr;9(8):650. doi: 10.21037/atm-20-7471.