- Home
- Featured Publications
- Center Publications
- Beta cell function in type 1 diabetes determined from clinical and fasting biochemical variables.
Beta cell function in type 1 diabetes determined from clinical and fasting biochemical variables.
Citation | “Beta Cell Function In Type 1 Diabetes Determined From Clinical And Fasting Biochemical Variables.”. Diabetologia, pp. 33-40. . |
Center | University of Washington |
Multicenter |
Multicenter
|
Author | John M Wentworth, Naiara G Bediaga, Lynne C Giles, Mario Ehlers, Stephen E Gitelman, Susan Geyer, Carmella Evans-Molina, Leonard C Harrison, Type 1 Diabetes TrialNet Study Group, Immune Tolerance Network Study Group |
Keywords | adult, beta cell function, Children, clinical trial, Immune Tolerance Network, Immune therapy, Linear model, TrialNet, type 1 diabetes |
Abstract |
AIMS/HYPOTHESIS: Beta cell function in type 1 diabetes is commonly assessed as the average plasma C-peptide concentration over 2 h following a mixed-meal test (CP). Monitoring of disease progression and response to disease-modifying therapy would benefit from a simpler, more convenient and less costly measure. Therefore, we determined whether CP could be reliably estimated from routine clinical variables. METHODS: Clinical and fasting biochemical data from eight randomised therapy trials involving participants with recently diagnosed type 1 diabetes were used to develop and validate linear models to estimate CP and to test their accuracy in estimating loss of beta cell function and response to immune therapy. RESULTS: A model based on disease duration, BMI, insulin dose, HbA, fasting plasma C-peptide and fasting plasma glucose most accurately estimated loss of beta cell function (area under the receiver operating characteristic curve [AUROC] 0.89 [95% CI 0.87, 0.92]) and was superior to the commonly used insulin-dose-adjusted HbA (IDAA1c) measure (AUROC 0.72 [95% CI 0.68, 0.76]). Model-estimated CP (CP) reliably identified treatment effects in randomised trials. CP, compared with CP, required only a modest (up to 17%) increase in sample size for equivalent statistical power. CONCLUSIONS/INTERPRETATION: CP, approximated from six variables at a single time point, accurately identifies loss of beta cell function in type 1 diabetes and is comparable to CP for identifying treatment effects. CP could serve as a convenient and economical measure of beta cell function in the clinic and as a primary outcome measure in trials of disease-modifying therapy in type 1 diabetes. |
Year of Publication |
2019
|
Journal |
Diabetologia
|
Volume |
62
|
Issue |
1
|
Number of Pages |
33-40
|
Date Published |
12/2019
|
ISSN Number |
1432-0428
|
DOI |
10.1007/s00125-018-4722-z
|
Alternate Journal |
Diabetologia
|
PMID |
30167735
|
PMCID |
PMC6518395
|
Download citation |