Factors associated with preservation of C-peptide levels at the diagnosis of type 1 diabetes

Aims: The level of C-peptide can identify individuals most likely to respond to immune interventions carried out to prevent pancreatic beta-cell damage. The aim of the study was to evaluate factors associated with C-peptide levels at type 1 diabetes (T1D) diagnosis. Methods: This study included 1098 children aged 2-17 with newly recognized T1D. Data were collected from seven Polish hospitals. The following variables were analyzed: date of birth, fasting C-peptide, HbA1c, sex, weight, height, pH at diabetes onset. Results: A correlation was observed between fasting C-peptide level and BMI-SDS (p = 0.0001), age (p = 0.0001), and HbAlc (p = 0.0001). The logistic regression model revealed that fasting C-peptide >= 0.7 ng/ml at diabetes diagnosis was dependent on weight, HbAlc, pH and sex (p < 0.0001). Overweight and obese children (n = 124) had higher fasting C-peptide (p = 0.0001) and lower HbAlc (p = 0.0008) levels than other subjects. Girls had higher fasting C-peptide (p = 0.036) and higher HbAlc (p = 0.026) levels than boys. Conclusion: Obese and overweight children are diagnosed with diabetes at an early stage with largely preserved C peptide levels. Increased awareness of T1D symptoms as well as improved screening and diagnostic tools are important to preserve C-peptide levels. There are noticeable gender differences in the course of diabetes already at T1D diagnosis. (C) 2018 Elsevier Inc. All rights reserved.