Beta cell function and ongoing autoimmunity in long-standing, childhood onset type 1 diabetes.
Diabetologia
; 59(12): 2722-2726, 2016 12.
Article
en En
| MEDLINE
| ID: mdl-27591853
ABSTRACT
AIMS/HYPOTHESIS:
This study aimed to determine the frequency of residual beta cell function in individuals with long-standing type 1 diabetes who were recruited at diagnosis, and relate this to baseline and current islet autoantibody profile.METHODS:
Two hour post-meal urine C-peptidecreatinine ratio (UCPCR) and islet autoantibodies were measured in samples collected from 144 participants (median age at diagnosis 11.7 years; 47% male), a median of 23 years (range 12-29 years) after diagnosis. UCPCR thresholds equivalent to mixed meal-stimulated serum C-peptide >0.001 nmol/l, ≥0.03 nmol/l and ≥0.2 nmol/l were used to define 'detectable', 'minimal' and 'residual/preserved') endogenous insulin secretion, respectively. Autoantibodies against GAD (GADA), islet antigen-2 (IA-2A), zinc transporter 8 (ZnT8A) and insulin (IAA) were measured by radioimmunoassay.RESULTS:
Endogenous C-peptide secretion was detectable in 51 participants (35.4%), including residual secretion in seven individuals (4.9%) and minimal secretion in 14 individuals (9.7%). In the 132 samples collected more than 10 years after diagnosis, 86 participants (65.2%) had at least one islet autoantibody 42 (31.8%) were positive for GADA, 69 (52.3%) for IA-2A and 14 of 104 tested were positive for ZnT8A (13.5%). The level of UCPCR was related to age at diagnosis (p = 0.002) and was independent of diabetes duration, and baseline or current islet autoantibody status. CONCLUSIONS/INTERPRETATION:
There is evidence of ongoing autoimmunity in the majority of individuals with longstanding diabetes. Endogenous insulin secretion continues for many years after diagnosis in individuals diagnosed with autoimmune-mediated type 1 diabetes above age 5. These findings suggest that some beta cells are protected from continued autoimmune attack in longstanding type 1 diabetes.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Autoinmunidad
/
Diabetes Mellitus Tipo 1
/
Células Secretoras de Insulina
Límite:
Adolescent
/
Adult
/
Child
/
Humans
Idioma:
En
Revista:
Diabetologia
Año:
2016
Tipo del documento:
Article
País de afiliación:
Reino Unido