Introduction and Objective: Understanding factors associated with C peptide (CP) preservation in type 1 diabetes (T1D) may aid interventions in the partial remission period. Fasting and stimulated CP or urinary CP to creatinine ratio (UCPCR) measure residual beta cell function.Methods: We utilized home monitoring CP collection with volumetric absorptive microsampling (VAMS) and a simplified mixed meal tolerance test (MMTT). Patients collected fasting and 90 minute CP VAMS after a standardized meal. We characterized correlation of VAMS MMTT CP with in clinic random serum CP and UCPCR.Results: We enrolled 34 islet autoantibody positive (Ab+) participants within 6 months of T1D onset. Age of T1D was 11.3 ± 3.4 years, 50% male, 85.3% ≥2 Ab+ and 14.7% 1 Ab+. HbA1c was 11.4 ± 2.9% at diagnosis and 6.3 ± 0.9% at enrollment. 53% of patients were diagnosed in diabetic ketoacidosis. Serum CP and UCPCR were collected at initial in clinic visit. Participants completed VAMS MMTT 10-14 days after enrollment. Random in clinic serum CP correlated with home fasting (R2=0.39, p=0.0005) and stimulated (R2=0.66, p<0.0001) CP. Random UCPCR did not correlate with serum or VAMS MMTT CP (Figure).Conclusion: Home VAMS MMTT CP correlated with in clinic random CP but not UCPCR, suggesting more standardized collection may be required than used in our study. VAMS home CP monitoring may be useful for longitudinal clinical research.
T.M. Triolo: None. F.A. Tensun: None. B.A. Palencia Li: None. H.C. Broncucia: None. T. Skeens: None. A. Steck: Advisory Panel; Sanofi-Aventis U.S. H.W. Davidson: Other Relationship; RSR Ltd.
NIH NIDDK (K23 DK136931, DK129310)
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