Using Glycated Albumin and Stimulated C-Peptide to Define Partial Remission in Type 1 Diabetes

被引:1
作者
Shi, Mei
Ji, Xiaolin
Xie, Yuting
Zhong, Ting
Tang, Rong
Fan, Li
Li, Xia [1 ]
机构
[1] Cent South Univ, Xiangya Hosp 2, Natl Clin Res Ctr Metab Dis, Key Lab Diabet Immunol,Minist Educ, Changsha, Peoples R China
基金
中国国家自然科学基金;
关键词
remission phase; type; 1; diabetes; glycated albumin; C-peptide; insulin resistance; INSULIN-RESISTANCE; METABOLIC-CONTROL; ADOLESCENTS; DIAGNOSIS; ONSET; DEFINITION; HEMOGLOBIN; MANAGEMENT; CHILDREN; MELLITUS;
D O I
10.3389/fendo.2022.938059
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ObjectiveTo propose a new definition of partial remission (PR) for patients with type 1 diabetes (T1D) of all-ages using insulin dose and glycated albumin (GA), and find the optimal cut-off values for stimulated C-peptide to diagnose PR in different age-groups. Research Design and MethodsPatients with newly diagnosed T1D (n=301) were included. GA/insulin dose was used to diagnose PR, and insulin dose-adjusted glycated albumin (IDAGA) was proposed to facilitate clinical application. The optimal diagnostic levels of IDAGA and stimulated C-peptide were determined in different age-groups (<= 12y, 12-18y and >= 18y). Furthermore, the diagnostic consistency between different PR definitions was studied. ResultsGA <= 23%/insulin dose <= 0.5u/kg/day was used to define PR, and IDAGA (GA (%) + 40 * insulin dose(u/kg/day)) <= 40 was feasible in all age-groups. Whereas, the optimal diagnostic level showed difference for stimulated C-peptide (265.5, 449.3 and 241.1 pmol/L for the <= 12y, 12-18y and >= 18y age-group, respectively). About 40% of patients met the PR definition by stimulated C-peptide but not GA/insulin dose or IDAGA, who showed dyslipidemia and higher insulin resistance. ConclusionsA new definition of the PR phase is proposed using GA/insulin dose, and the calculated IDAGA <= 40 applies to all age-groups. The stimulated C-peptide to diagnose PR is the highest in the 12-18y age-group, which reflects the effect of puberty on metabolism. For patients with insulin resistance, it is not recommended to use stimulated C-peptide alone to diagnose PR.
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页数:9
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