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Preserved beta-cell function in type 1 diabetes is linked to better glycemic control, indicated by improved continuous glucose monitoring (CGM) metrics. This suggests residual islet function may reduce long-term complication risks.

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Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Diabetes Research

Background:

  • Residual islet function's impact on type 1 diabetes (T1D) glycemic control remains unclear.
  • Understanding this relationship is crucial for optimizing T1D management and predicting long-term outcomes.

Purpose of the Study:

  • To investigate the association between residual beta-cell function and continuous glucose monitoring (CGM) metrics in individuals with T1D.
  • To explore how urinary C-peptide to creatinine ratio (UCPCR) correlates with glycemic control parameters.

Main Methods:

  • Cross-sectional study of 489 individuals with T1D.
  • Assessed beta-cell function via urinary C-peptide to creatinine ratio (UCPCR).
  • Evaluated alpha-cell function using fasting plasma glucagon/glucose ratios.
  • CGM data analyzed for time in range (TIR), time below range (TBR), time above range (TAR), and glucose coefficient of variance (CV).

Main Results:

  • Nearly half (49.4%) of T1D participants had detectable UCPCR.
  • Higher UCPCR correlated with improved CGM metrics: higher TIR, lower TBR, lower TAR, and lower glucose CV.
  • Increased UCPCR also associated with lower HbA1c and reduced total daily insulin dose.
  • Higher glucagon/glucose ratios correlated with longer TIR.

Conclusions:

  • Preserved beta-cell function, indicated by higher UCPCR, is associated with significantly better CGM-derived glycemic control.
  • These findings suggest that residual beta-cell function may contribute to a lower risk of long-term diabetes complications.