These authors contributed equally.
Age-dependent decline of β-cell function in type 1 diabetes after diagnosis: a multi-centre longitudinal study
Article first published online: 29 OCT 2013
© 2013 John Wiley & Sons Ltd
Diabetes, Obesity and Metabolism
Volume 16, Issue 3, pages 262–267, March 2014
How to Cite
Barker, A., Lauria, A., Schloot, N., Hosszufalusi, N., Ludvigsson, J., Mathieu, C., Mauricio, D., Nordwall, M., Van der Schueren, B., Mandrup-Poulsen, T., Scherbaum, W. A., Weets, I., Gorus, F. K., Wareham, N., Leslie, R. D. and Pozzilli, P. (2014), Age-dependent decline of β-cell function in type 1 diabetes after diagnosis: a multi-centre longitudinal study. Diabetes, Obesity and Metabolism, 16: 262–267. doi: 10.1111/dom.12216
- Issue published online: 4 FEB 2014
- Article first published online: 29 OCT 2013
- Accepted manuscript online: 1 OCT 2013 01:12PM EST
- Manuscript Revised: 14 SEP 2013
- Manuscript Accepted: 14 SEP 2013
- Manuscript Received: 24 JUL 2013
- Centro Internazionale Studi Diabete
- Instituto Carlos III, Spain. Grant Number: FIS 061104
- β cell;
- clinical trial;
- type 1 diabetes
C-peptide secretion is currently the only available clinical biomarker to measure residual β-cell function in type 1 diabetes. However, the natural history of C-peptide decline after diagnosis can vary considerably dependent upon several variables. We investigated the shape of C-peptide decline over time from type 1 diabetes onset in relation to age at diagnosis, haemoglobin A1c (HbA1c) levels and insulin dose.
We analysed data from 3929 type 1 diabetes patients recruited from seven European centres representing all age groups at disease onset (childhood, adolescence and adulthood). The influence of the age at onset on β-cell function was investigated in a longitudinal analysis at diagnosis and up to 5-years follow-up.
Fasting C-peptide (FCP) data at diagnosis were available in 3668 patients stratified according to age at diagnosis in four groups (<5 years, n = 344; >5 years < 10 years, n = 668; >10 years < 18 years, n = 991; >18 years, n = 1655). FCP levels were positively correlated with age (p < 0.001); the subsequent decline in FCP over time was log-linear with a greater decline rate in younger age groups (p < 0.0001).
This study reveals a positive correlation between age at diagnosis of type 1 diabetes and FCP with a more rapid decline of β-cell function in the very young patients. These data can inform the design of clinical trials using C-peptide values as an end-point for the effect of a given treatment.