C-peptide in the classification of diabetes in children and adolescents.

Summary, in English

C-peptide in the classification of diabetes in children and adolescents. Aim: To report C-peptide results in newly diagnosed patients and the relation to clinical diagnosis of diabetes. Methods: A nation-wide cohort, the Better Diabetes Diagnosis study was used to determine serum C-peptide at diagnosis in 2734 children and adolescents. Clinical data were collected at diagnosis and follow-up. C-peptide was determined in a validated and controlled time-resolved fluoroimmunoassay. Results: The clinical classification of diabetes, before any information on human leukocyte antigen, islet autoantibodies, or C-peptide was received, was type 1 diabetes (T1D) in 93%, type 2 diabetes (T2D) in 1.9%, maturity onset diabetes of the young (MODY) in 0.8%, secondary diabetes (0.6%), while 3.3% could not be classified. In a random, non-fasting serum sample at diagnosis, 56% of the patients had a C-peptide value >0.2 nmol/L. Children classified as T2D had the highest mean C-peptide (1.83 + 1.23 nmol/L) followed by MODY (1.04 ± 0.71 nmol/L) and T1D (0.28 ± 0.25 nmol/L). Only 1/1037 children who had C-peptide <0.2 nmol/L at diagnosis was classified with a type of diabetes other than T1D. Predictive value of C-peptide >1.0 nmol/L for the classification of either T2D or MODY was 0.46 [confidence interval 0.37-0.58]. Conclusions: More than half of children with newly diagnosed diabetes have clinically important residual beta-cell function. As the clinical diagnosis is not always straightforward, a random C-peptide taken at diagnosis may help to classify diabetes. There is an obvious use for C-peptide determinations to evaluate beta-cell function in children with diabetes.

• Författare: Johnny Ludvigsson; Annelie Carlsson; G Forsander; Sten Ivarsson; I Kockum; Åke Lernmark; Bengt Lindblad; C Marcus; U Samuelsson
• Avdelning/ar: Pediatrik, Lund; Pediatrisk autoimmunitet; Pediatrisk endokrinologi; Celiaki och diabetes; Vaskulära sjukdomar - kliniska studier; EXODIAB: Excellence of Diabetes Research in Sweden
• Publiceringsår: 2012
• Språk: Engelska
• Sidor: 45-50
• Publikation/Tidskrift/Serie: Pediatric Diabetes
• Volym: 13
• Länkar: http://www.ncbi.nlm.nih.gov/pubmed/21910810?dopt=Abstract; http://dx.doi.org/10.1111/j.1399-5448.2011.00807.x
• Dokumenttyp: Artikel i tidskrift
• Förlag: Wiley-Blackwell
• Ämne: Pediatrics; Endocrinology and Diabetes
• Status: Published
• Forskningsgrupp: Pediatric Autoimmunity; Paediatric Endocrinology; Celiac Disease and Diabetes Unit; Vascular Diseases - Clinical Research
• ISBN/ISSN/Övrigt: ISSN: 1399-543X