TY - GEN

T1 - Analyses of the rate of decline in stimulated c-peptide 12 months after diagnosis in children with newly diag-nosed type 1 diabetes. results from the Hvidoere study group on childhood diabetes

AU - Andersen, Marie Louise Max

AU - Porksen, S.

AU - Nielsen, L.B.

AU - Svensson, Jannete

AU - Johannesen, Jesper

AU - Hougaard, P

AU - Jørgensen, J V

AU - Thomsen, J

AU - Hertel, N T

AU - Petersen, J S

AU - Karlsen, A E

AU - Hansen, Lars

AU - Mortensen, Henrik Bindesbøl

PY - 2010

Y1 - 2010

N2 - Objectives: Direct measurement of C-peptide has been recommended to provide the most appropriate primary outcome in trials evaluating the efficacy of therapies to preserve beta-cell function. The aim of the present study was to quantitatively characterize the natural history of disease progression as assessed by stimulated C-peptide the first 12 months after diagnosis in children with new onset T1D in two independent cohorts collected over a time interval of 6 years. Furthermore the purpose was to assess whether the natural history of disease has changed over time. Materials and methods: The International Hvidoere cohort, year 1999–2000: 275 children from 22 paediatric centers; the Danish cohort, year 2005–2006: 130 children from 4 paediatric centers. All patients went through a 90-minutes Boost-test 1, 3 (only the Danish cohort), 6, 12 months to characterize the residual betacell function. All samples were centrally analyzed. The linearity of the slope of decline in stimulated C-peptide was analyzed from 3–12 months on a logarithmic scale. Linear mixed-effect models were used to determine cohort differences. Results: Maximum values of stimulated C-peptide were reached at a duration of three months. Thereafter there was a linear decline in stimulated C-peptide for all age groups above 5 years in both cohorts. The mean value for the disappearance rate in stimulated C-peptide was 7.2 ± 0.9%/month for the Hvidoere and 9.4 ± 0.8%/month for the Danish cohort (NS, P = 0.12). The combined slope for both cohorts was calculated to 8.0 ± 0.7%/ month.This is in the same range as the value reported of 0.019 nmol/l/month (1982-1985) by Wallensteen corresponding to a relative change of 9.5%/month. Conclusion: Thus, the natural history of disease progression during the first 12 months after diagnosis has not changed considerably in new onset T1D populations during the last 20 years, despite more intensive insulin treatment regimens has been introduced during this period.

AB - Objectives: Direct measurement of C-peptide has been recommended to provide the most appropriate primary outcome in trials evaluating the efficacy of therapies to preserve beta-cell function. The aim of the present study was to quantitatively characterize the natural history of disease progression as assessed by stimulated C-peptide the first 12 months after diagnosis in children with new onset T1D in two independent cohorts collected over a time interval of 6 years. Furthermore the purpose was to assess whether the natural history of disease has changed over time. Materials and methods: The International Hvidoere cohort, year 1999–2000: 275 children from 22 paediatric centers; the Danish cohort, year 2005–2006: 130 children from 4 paediatric centers. All patients went through a 90-minutes Boost-test 1, 3 (only the Danish cohort), 6, 12 months to characterize the residual betacell function. All samples were centrally analyzed. The linearity of the slope of decline in stimulated C-peptide was analyzed from 3–12 months on a logarithmic scale. Linear mixed-effect models were used to determine cohort differences. Results: Maximum values of stimulated C-peptide were reached at a duration of three months. Thereafter there was a linear decline in stimulated C-peptide for all age groups above 5 years in both cohorts. The mean value for the disappearance rate in stimulated C-peptide was 7.2 ± 0.9%/month for the Hvidoere and 9.4 ± 0.8%/month for the Danish cohort (NS, P = 0.12). The combined slope for both cohorts was calculated to 8.0 ± 0.7%/ month.This is in the same range as the value reported of 0.019 nmol/l/month (1982-1985) by Wallensteen corresponding to a relative change of 9.5%/month. Conclusion: Thus, the natural history of disease progression during the first 12 months after diagnosis has not changed considerably in new onset T1D populations during the last 20 years, despite more intensive insulin treatment regimens has been introduced during this period.

M3 - Conference article

JO - Pediatric Diabetes

JF - Pediatric Diabetes

SN - 1399-543X

ER -