Natural History of β-Cell Function in Type 1 Diabetes
- 1 December 2005
- journal article
- review article
- Published by American Diabetes Association in Diabetes
- Vol. 54 (suppl_2), S32-S39
- https://doi.org/10.2337/diabetes.54.suppl_2.s32
Abstract
Despite extensive and ongoing investigations of the immune mechanisms of autoimmune diabetes in humans and animal models, there is much less information about the natural history of insulin secretion before and after the clinical presentation of type 1 diabetes and the factors that may affect its course. Studies of insulin production previously published and from the Diabetes Prevention Trial (DPT)-1 suggest that there is progressive impairment in insulin secretory responses but the reserve in response to physiological stimuli may be significant at the time of diagnosis, although maximal responses are more significantly impaired. Other factors, including insulin resistance, may play a role in the timing of clinical presentation along this continuum. The factors that predict the occurrence and rapidity of decline in β-cell function are still largely unknown, but most studies have identified islet cell autoantibodies as predictors of future decline and age as a determinant of residual insulin production at diagnosis. Historical as well as recent clinical experience has emphasized the importance of residual insulin production for glycemic control and prevention of end-organ complications. Understanding the modifiers and predictors of β-cell function would allow targeting immunological approaches to those individuals most likely to benefit from therapy.Keywords
This publication has 87 references indexed in Scilit:
- Preservation of C-peptide secretion in subjects at high risk of developing type 1 diabetes mellitus - a new surrogate measure of non-progression?Pediatric Diabetes, 2004
- Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescentsThe Journal of Pediatrics, 2004
- Use of an islet cell antibody assay to identify type 1 diabetic patients with rapid decrease in C-peptide levels after clinical onset. Belgian Diabetes Registry.Diabetes Care, 2000
- Interactions of age, islet cell antibodies, insulin autoantibodies, and first-phase insulin response in predicting risk of progression to IDDM in ICA+ relatives: the ICARUS data set. Islet Cell Antibody Register Users StudyDiabetes, 1996
- Glutamate decarboxylase-, insulin-, and islet cell-antibodies and HLA typing to detect diabetes in a general population-based study of Swedish children.JCI Insight, 1995
- A Comparison of Childhood and Adult Type I Diabetes MellitusNew England Journal of Medicine, 1989
- Abnormal Patterns of Insulin Secretion in Non-Insulin-Dependent Diabetes MellitusNew England Journal of Medicine, 1988
- Natural Course of Insulin Resistance in Type I DiabetesNew England Journal of Medicine, 1986
- Use of biosynthetic human C-peptide in the measurement of insulin secretion rates in normal volunteers and type I diabetic patients.JCI Insight, 1986
- B-cell function and blood glucose control in insulin dependent diabetics within the first month of insulin treatmentDiabetologia, 1977