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C-peptide in the classification of diabetes in children and adolescents.
Pediatr Diabetes 2012; 13(1):45-50PD

Abstract

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.

Authors+Show Affiliations

Division of Pediatrics and Diabetes Research Center, Department of Clinical and Experimental Medicine, Linköping University Hospital, Linköping, Sweden. johnny.ludvigsson@lio.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21910810

Citation

Ludvigsson, J, et al. "C-peptide in the Classification of Diabetes in Children and Adolescents." Pediatric Diabetes, vol. 13, no. 1, 2012, pp. 45-50.
Ludvigsson J, Carlsson A, Forsander G, et al. C-peptide in the classification of diabetes in children and adolescents. Pediatr Diabetes. 2012;13(1):45-50.
Ludvigsson, J., Carlsson, A., Forsander, G., Ivarsson, S., Kockum, I., Lernmark, A., ... Samuelsson, U. (2012). C-peptide in the classification of diabetes in children and adolescents. Pediatric Diabetes, 13(1), pp. 45-50. doi:10.1111/j.1399-5448.2011.00807.x.
Ludvigsson J, et al. C-peptide in the Classification of Diabetes in Children and Adolescents. Pediatr Diabetes. 2012;13(1):45-50. PubMed PMID: 21910810.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - C-peptide in the classification of diabetes in children and adolescents. AU - Ludvigsson,J, AU - Carlsson,A, AU - Forsander,G, AU - Ivarsson,S, AU - Kockum,I, AU - Lernmark,A, AU - Lindblad,B, AU - Marcus,C, AU - Samuelsson,U, Y1 - 2011/09/13/ PY - 2011/9/14/entrez PY - 2011/9/14/pubmed PY - 2012/6/2/medline SP - 45 EP - 50 JF - Pediatric diabetes JO - Pediatr Diabetes VL - 13 IS - 1 N2 - 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. SN - 1399-5448 UR - https://www.unboundmedicine.com/medline/citation/21910810/C_peptide_in_the_classification_of_diabetes_in_children_and_adolescents_ L2 - https://doi.org/10.1111/j.1399-5448.2011.00807.x DB - PRIME DP - Unbound Medicine ER -