[Prediction of clinical remission using the C-peptide level in type 1 diabetes in children]

The aim of the study was to identify individual, clinical and metabolic factors that predict the C-peptide levels and appearance of clinical partial remission during the first year of type 1 diabetes (T1D) in children.

197 type 1 diabetic patients (84 female and 113 male, mean age 10.4 years) were examined. C-peptide levels were detected by radioimmunoassay at the diagnosis and after 3, 6 and 12 months of the disease.

Median C-peptide level at onset was 0.17 pmol/mL (0.11-0.32), peaked in the 3rd month (0.27 pmol/mL, 0.15-0.43; p<0.001) and declined thereafter - 0.21 pmol/mL (0.1-0.34) in the 6th month and 0.13 pmol/mL (0.05-0.26) at the 12th month of the disease. Logistic regression showed that younger age, low pH and higher HbA1c (glycated haemoglobin) at the onset were associated with the "lower" (<0.28 pmol/mL) C-peptide level at the diagnosis. The presence of clinical partial remission was observed in 31% of children. Patients with remission had higher C-peptide levels observed in the first 6 months of T1D than children without clinical remission. Receiver operating characteristic (ROC) curve method was used for the estimation of the threshold of C-peptide level at the onset for the prediction of the clinical remission during the first year of T1D (0.141 pmol/mL, AUC (95%CI) = 0.608 (0.53-0.68)).

Concluding, higher C-peptide level is associated with the appearance of clinical partial remission during the first six months of T1D. C-peptide level may be a good predictor of the clinical partial remission during the first year of T1D.