High residual C-peptide likely contributes to glycemic control in type 1 diabetes

Rickels, Michael R.; Evans‐Molina, Carmella; Bahnson, Henry T.; Ylescupidez, Alyssa; Nadeau, Kristen J.; Wu, Hao; Clements, Mark A.; Sherr, Jennifer; Pratley, Richard E.; Hannon, Tamara S; Shah, Viral N.; Miller, Kellee M.; Greenbaum, Carla J.

doi:10.1172/jci134057

Cited by 91 publications

(110 citation statements)

References 69 publications

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“…Between-group differences within the first 12 h postexercise mirrored those seen within the whole group analysis, with time spent in euglycemia significantly higher for Cpep high than Cpep low and Cpep und (P 5 0.023). When extended out to 24 h, the trends persisted, with Results from the baseline observational free-living CGM data are similar to those of Rickels et al (14). While they demonstrated that individuals with C-peptide .400 pmol/L spent more time in a state of euglycemia under free-living conditions, there were no differences between their negative, low (17-200 pmol/L), and what they have defined as intermediate (200-400 pmol/L) groups.…”

Section: Autoantibody Statussupporting

confidence: 81%

Postexercise Glycemic Control in Type 1 Diabetes Is Associated With Residual β-Cell Function

et al. 2020

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To investigate the impact of residual b-cell function on continuous glucose monitoring (CGM) outcomes following acute exercise in people with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS Thirty participants with T1D for ‡3 years were recruited. First, participants wore a blinded CGM unit for 7 days of free-living data capture. Second, a 3-h mixed-meal test assessed stimulated C-peptide and glucagon. Peak C-peptide was used to allocate participants into undetectable (Cpep und <3 pmol/L), low (Cpep low 3-200 pmol/L), or high (Cpep high >200 pmol/L) C-peptide groups. Finally, participants completed 45 min of incline treadmill walking at 60% VO 2peak followed by a further 48-h CGM capture. RESULTS CGM parameters were comparable across groups during the free-living observation week.In the 12-and 24-h postexercise periods (12 h and 24 h), the Cpep high group had a significantly greater amount of time spent with glucose 3

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Section: Autoantibody Statussupporting

confidence: 81%

Postexercise Glycemic Control in Type 1 Diabetes Is Associated With Residual β-Cell Function

et al. 2020

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“…Persistent endogenous beta cell function in type 1 diabetes is associated with greater potential for improved glycaemic control and reduced complications [36]. A stimulated Cpeptide measurement represents a candidate for defining subcategories of type 1 diabetes with different treatment aims.…”

Section: Precision Diagnosis In Clinical Practicementioning

confidence: 99%

Precision medicine in diabetes: a Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

et al. 2020

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The convergence of advances in medical science, human biology, data science and technology has enabled the generation of new insights into the phenotype known as 'diabetes'. Increased knowledge of this condition has emerged from populations around the world, illuminating the differences in how diabetes presents, its variable prevalence and how best practice in treatment varies between populations. In parallel, focus has been placed on the development of tools for the application of precision medicine to numerous conditions. This Consensus Report presents the American Diabetes Association (ADA) Precision Medicine in Diabetes Initiative in partnership with the European Association for the Study of Diabetes (EASD), including its mission, the current state of the field and prospects for the future. Expert opinions are presented on areas of precision diagnostics and precision therapeutics (including prevention and treatment) and key barriers to and opportunities for implementation of precision diabetes medicine, with better care and outcomes around the globe, are highlighted. Cases where precision diagnosis is already feasible and effective (i.e. monogenic forms of diabetes) are presented, while the major hurdles to the global implementation of precision diagnosis of complex forms of diabetes are discussed. The situation is similar for precision therapeutics, in which the appropriate therapy will often change over time owing to the manner in which diabetes evolves within individual patients. This Consensus Report describes a foundation for precision diabetes medicine, while highlighting what remains to be done to realise its potential. This, combined with a subsequent, detailed evidence-based review (due 2022), will provide a roadmap for precision medicine in diabetes that helps improve the quality of life for all those with diabetes.

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“…An individual must have had a clinical diagnosis of autoimmune type 1 diabetes, as determined by the physician/study investigator, and either islet cell antibodies present or, if antibodies were negative or unknown, then insulin must have been started at or shortly after diagnosis and used continually thereafter (except in the case of a pancreas or islet cell transplant). (23,24) Participants had BMI < 30 kg/m 2 , and glycated hemoglobin (HbA1c) <9.0.…”

Section: Subjectsmentioning

confidence: 99%

“…The details of the study protocol and procedures was published recently. (23) This study was approved by the IRB of seven participating sites. MMTT A 2-hour MMTT with a standardized liquid meal (Boost High Protein; Nestle HealthCare Nutrition, Inc., Bridgewater, NJ, USA; 6 mL/kg up to 360 mL) was conducted after a 10-hour overnight fast as an assessment of islet hormone secretion in response to nutrient ingestion.…”

Section: Subjectsmentioning

confidence: 99%

“…The results of the tracer study used to derive measures of hepatic and peripheral insulin sensitivity have been published. (23) BTMs BTM analyses were performed on the second freeze-thaw cycle of the blood samples (ie, samples were thawed one time prior to use). Post-MMTT C-peptide levels were measured by two-site immunoenzyomometric assays (Tosoh 2000 auto-analyzer; Tosoh Bioscience, San Francisco, CA, USA).…”

Section: Hecmentioning

confidence: 99%

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Acute Hyperinsulinemia Alters Bone Turnover in Women and Men With Type 1 Diabetes

et al. 2020

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Type 1 diabetes (T1D) increases fracture risk across the lifespan. The low bone turnover associated with T1D is thought to be related to glycemic control, but it is unclear whether peripheral hyperinsulinemia due to dependence on exogenous insulin has an independent effect on suppressing bone turnover. The purpose of this study was to test the bone turnover marker (BTM) response to acute hyperinsulinemia. Fifty‐eight adults aged 18 to 65 years with T1D over 2 years were enrolled at seven T1D Exchange Clinic Network sites. Participants had T1D diagnosis between age 6 months to 45 years. Participants were stratified based on their residual endogenous insulin secretion measured as peak C‐peptide response to a mixed meal tolerance test. BTMs (CTX, P1NP, sclerostin [SCL], osteonectin [ON], alkaline phosphatase [ALP], osteocalcin [OCN], osteoprotegerin [OPG], osteopontin [OPN], and IGF‐1) were assessed before and at the end of a 2‐hour hyperinsulinemic‐euglycemic clamp (HEC). Baseline ON (r = −0.30, p = .022) and OCN (r = −0.41, p = .002) were negatively correlated with age at T1D diagnosis, but baseline BTMs were not associated with HbA1c. During the HEC, P1NP decreased significantly (−14.5 ± 44.3%; p = .020) from baseline. OCN, ON, and IGF‐1 all significantly increased (16.0 ± 13.1%, 29.7 ± 31.7%, 34.1 ± 71.2%, respectively; all p < .001) during the clamp. The increase in SCL was not significant (7.3 ± 32.9%, p = .098), but the decrease in CTX (−12.4 ± 48.9, p = .058) neared significance. ALP and OPG were not changed from baseline (p = .23 and p = .77, respectively). Baseline ON and SCL were higher in men, but OPG was higher in women (all p ≤ .029). SCL was the only BTM that changed differently in women than men. There were no differences in baseline BTMs or change in BTMs between C‐peptide groups. Exogenous hyperinsulinemia acutely alters bone turnover, suggesting a need to determine whether strategies to promote healthy remodeling may protect bone quality in T1D. © 2020 American Society for Bone and Mineral Research © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

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High residual C-peptide likely contributes to glycemic control in type 1 diabetes

Cited by 91 publications

References 69 publications

Postexercise Glycemic Control in Type 1 Diabetes Is Associated With Residual β-Cell Function

Postexercise Glycemic Control in Type 1 Diabetes Is Associated With Residual β-Cell Function

Precision medicine in diabetes: a Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Acute Hyperinsulinemia Alters Bone Turnover in Women and Men With Type 1 Diabetes

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