Factors related to β-cell residual function in the diagnosis of type 1 diabetes mellitus

• Autor(a) principal: Gonçalves,Vera
• Data de Publicação: 2023
• Outros Autores: Teixeira,Liliana, Freitas,Joana, Oliveira,Maria João, Borges,Teresa
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-07542023000100009
• topic: β-cell function; c-peptide; type 1 diabetes mellitus

Abstract Objective: To identify factors associated with C-peptide levels at the diagnosis of type 1 diabetes mellitus (T1DM). Material and Methods: Retrospective review of the clinical records of patients with newly diagnosed T1DM admitted to a Portuguese reference center between August 2010 and July 2019. Results: The study included 109 subjects, with a mean age at T1DM diagnosis of 8.6 years and 29.4% already showing puberty development. The mean body mass index (BMI) z-score was 0.09. Subjects presented a median fasting C-peptide level of 0.46 ng/mL and a median hemoglobin A1C (HbA1C) of 10.85%. Diabetic ketoacidosis was identified in 22% of patients. A positive correlation was found between fasting C-peptide levels and age at diagnosis (p<0.001) and between fasting C-peptide levels and BMI z-score (p=0.041). Higher C-peptide levels were found in overweight/obese (p=0.008) and pubertal (p<0.001) individuals. C-peptide levels were found to be correlated with serum bicarbonate (p=0.005) but not with venous pH, HbA1C, or previous symptom duration. No statistically significant differences were observed in fasting C-peptide levels according to gender, diabetes autoantibodies, T1DM family history, or seasonality. Conclusion: Older, pubertal, and overweight/obese children presented higher C-peptide levels. In the acute setting, serum bicarbonate was the biochemical parameter that best correlated with residual β-cell function.