In een recent onderzoek worden de resultaten gepresenteerd van de insuline afgifte na een test maaltijd bij mensen met langer bestaande type 1 diabetes.
Het abstract is als volgt:
Aims: This study aims to evaluate the stability of C-peptide over time and to compare fasting C-peptide and C-peptide response after Mixed-Meal Tolerance Test (MMTT) at T90 or T120 with C-peptide area under the curve (AUC) in long-standing type 1 diabetes.
Methods: We included 607 type 1 diabetes individuals with diabetes duration >5 years. C-peptide concentrations (ultrasensitive assay) were collected in the fasting state, and in a subpopulation after MMTT (T0, just prior to, T30-T60-T90-T120, 30-120 minutes after ingestion of Mixed-meal) (n=168). Fasting C-peptide concentrations (in n=535) at Year 0 and Year 1 were compared. The clinical determinants associated with residual C-peptide secretion and the correspondence of C-peptide at MMTT T90 / T120 and total AUC were assessed.
Results: 153 participants (25%) had detectable fasting serum C-peptide (i.e ≥ 3.8 pmol/L). Fasting C-peptide was significantly lower at Year 1 (P <0.001, effect size = -0.16). Participants with higher fasting C-peptide had a higher age at diagnosis, shorter disease duration and were less frequently insulin pump users. Overall, 109 of 168 (65%) participants had both non-detectable fasting and post-meal serum C-peptide concentrations. The T90 and T120 C-peptide values at MMTT were concordant with total AUC. In 17 (10%) individuals, C-peptide was only detectable at MMTT and not in the fasting state.
Conclusions: Stimulated C-peptide was detectable in an additional 10% of individuals compared with fasting in individuals with >5 years diabetes duration. T90 and T120 MMTT measurements showed good concordance with the MMTT total AUC. Overall there was a decrease of C-peptide at 1-year follow-up.
Het volledige artikel is hier te lezen: https://onlinelibrary.wiley.com/doi/10.1111/dme.15012
Het onderzoek werd mogelijk gemaakt door het JDRF (Juvenile Diabetes Research Foundation) en het DiabetesFonds Nederland.