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Twenty-four hour profiles of plasma C-peptide in type 1 (insulin-dependent) diabetic children
Insights
Children with Type 1 diabetes who produce C-peptide have better blood glucose control. Residual beta cell function in diabetic children shows physiological insulin secretion linked to blood glucose levels.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Diabetes Mellitus Research
Background:
- Type 1 diabetes is characterized by autoimmune destruction of pancreatic beta cells.
- Residual beta cell function, indicated by C-peptide levels, varies among children with Type 1 diabetes.
- Understanding endogenous insulin secretion patterns is crucial for optimizing diabetes management.
Purpose of the Study:
- To investigate the 24-hour profiles of plasma C-peptide in children with Type 1 diabetes.
- To correlate C-peptide levels with blood glucose fluctuations.
- To assess the impact of residual beta cell function on glycemic control.
Main Methods:
- Collected 24-hour plasma C-peptide profiles in 15 children with Type 1 diabetes.
- Measured simultaneous blood glucose levels.
- Analyzed correlations between C-peptide and blood glucose.
- Calculated mean M-value as an index of glycemic control.
Main Results:
- Plasma C-peptide was detectable in 6 children; 4 were 'C-peptide producers' with elevated peak levels.
- A significant correlation (r > 0.50, p < 0.05) was observed between C-peptide and blood glucose in children with residual beta cell function.
- 'C-peptide producers' exhibited lower post-breakfast peak blood glucose (10.2 +/- 1.7 mmol/l) compared to non-producers (18.7 +/- 1.7 mmol/l).
- Mean M-values were significantly lower in 'C-peptide producers' (p < 0.05), indicating better glycemic control.
Conclusions:
- Residual functioning beta cells in diabetic children secrete insulin physiologically, responding to blood glucose levels.
- Endogenous insulin secretion provides a post-prandial dampening effect, improving glycemic control.
- The pattern of injected insulin is more critical for glycemic management in Type 1 diabetic children lacking residual endogenous insulin secretion.
Abstract:
Twenty-four hour profiles of plasma C-peptide, an index of endogenous insulin secretion, were performed in 15 Type 1 (insulin-dependent) diabetic children. Plasma C-peptide was detectable in six children, of whom four ('C-peptide producers') had peak values above normal fasting levels. In each of the six children with residual B cell function, there was a close correlation between plasma C-peptide and simultaneous blood glucose (r greater than 0.50, p less than 0.05). Post-breakfast peak blood glucose was 10.2 +/- 1.7 mmol/l (mean +/- SEM) in the 'C-peptide producers' and 18.7 +/- 1.7 mmol/l in the 11 children with low or no detectable C-peptide. Mean M-value, an index of deviation from an ideal blood glucose, was lower in the 'C-peptide producers' (p less than 0.05). It is concluded that residual functioning B cells in diabetic children behave physiologically in that insulin secretion fluctuates in accordance with the prevailing blood glucose; and that the pattern of action of injected insulin is more critical in non-C peptide producers who lack the post-prandial dampening effect provided by residual endogenous insulin secretion.