Mixed-meal tolerance test to assess residual beta-cell secretion: Beyond the area-under-curve of plasma C-peptide concentration.
Willemsen, Ruben H
MetadataShow full item record
Ruan, Y., Willemsen, R. H., Wilinska, M., Tauschmann, M., Dunger, D., & Hovorka, R. (2019). Mixed-meal tolerance test to assess residual beta-cell secretion: Beyond the area-under-curve of plasma C-peptide concentration.. Pediatric diabetes, 20 (3), 282-285. https://doi.org/10.1111/pedi.12816
Abstract Aims Residual beta-cell secretion in type 1 diabetes is commonly assessed by area-under-curve of plasma C-peptide concentration (AUCCpep) following mixed-meal tolerance test (MMTT). We aimed to investigate alternative measures of beta-cell responsiveness. Methods We analysed data from 32 youth (age 7 to 17years) undergoing MMTT within 6months of type 1 diabetes diagnosis. We related AUCCpep with (i) validated mechanistic index of postprandial beta-cell responsiveness MI accounting for glucose level during MMTT, and (ii) pragmatic marker calculated as baseline plasma C peptide concentration corrected for baseline plasma glucose concentration. Results Postprandial responsiveness MI was correlated with age and BMI SDS (Rs=0.66 and 0.44, P<0.01 and P<0.05) and was more correlated with glycated haemoglobin than AUCCpep (Rs=0.79, P=0.04). The pragmatic marker was highly correlated with AUCCpep (Rs=0.94, P<0.01). Conclusions Postprandial responsiveness MI may be more relevant to glucose control than AUCCpep. Baseline C-peptide corrected for baseline glucose appears to be a suitable surrogate of AUCCpep if MMTT is not performed.
Humans, Diabetes Mellitus, Type 1, C-Peptide, Blood Glucose, Diagnostic Techniques, Endocrine, Area Under Curve, Feasibility Studies, Postprandial Period, Adolescent, Child, Female, Male, Insulin-Secreting Cells, Meals, Glycated Hemoglobin A, Insulin Secretion
Department of Health (via National Institute for Health Research (NIHR)) (EME 14/23/09)
European Commission Horizon 2020 (H2020) Societal Challenges (731560)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Helmsley Charitable Trust (#2016PG-T1D045)
Wellcome Trust (100574/Z/12/Z)
European Commission Horizon 2020 (H2020) Societal Challenges (115797 INNODIA)
External DOI: https://doi.org/10.1111/pedi.12816
This record's URL: https://www.repository.cam.ac.uk/handle/1810/288800