Abstract | OBJECTIVE: RESEARCH DESIGN AND METHODS: We examined 2-h OGTTs of participants in the Diabetes Prevention Trial Type 1 (DPT-1) and TrialNet Pathway to Prevention (PTP) studies. We included 706 DPT-1 participants (mean ± SD age, 13.84 ± 9.53 years; BMI Z-score, 0.33 ± 1.07; 56.1% male) and 3,720 PTP participants (age, 16.01 ± 12.33 years; BMI Z-score, 0.66 ± 1.3; 49.7% male). Log-rank testing and Cox regression analyses with adjustments (age, sex, race, BMI Z-score, HOMA- insulin resistance, and peak glucose/ C-peptide levels, respectively) were performed. RESULTS: In each of DPT-1 and PTP, higher 5-year diabetes progression risk was seen in those with time to peak glucose >30 min and time to peak C-peptide >60 min (P < 0.001 for all groups), before and after adjustments. In models examining strength of association with diabetes development, associations were greater for time to peak C-peptide versus peak C-peptide value (DPT-1: χ2 = 25.76 vs. χ2 = 8.62; PTP: χ2 = 149.19 vs. χ2 = 79.98; all P < 0.001). Changes in the percentage of individuals with delayed glucose and/or C-peptide peaks were noted over time. CONCLUSIONS: In two independent at-risk populations, we show that those with delayed OGTT peak times for glucose or C-peptide are at higher risk of diabetes development within 5 years, independent of peak levels. Moreover, time to peak C-peptide appears more predictive than the peak level, suggesting its potential use as a specific biomarker for diabetes progression.
|
Authors | Michael G Voss, David D Cuthbertson, Mario M Cleves, Ping Xu, Carmella Evans-Molina, Jerry P Palmer, Maria J Redondo, Andrea K Steck, Markus Lundgren, Helena Larsson, Wayne V Moore, Mark A Atkinson, Jay M Sosenko, Heba M Ismail, DPT-1 and TrialNet Study Groups |
Journal | Diabetes care
(Diabetes Care)
Vol. 44
Issue 10
Pg. 2329-2336
(10 2021)
ISSN: 1935-5548 [Electronic] United States |
PMID | 34362815
(Publication Type: Clinical Trial, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
|
Copyright | © 2021 by the American Diabetes Association. |
Chemical References |
|
Topics |
- Adolescent
- Adult
- Blood Glucose
- C-Peptide
- Child
- Child, Preschool
- Diabetes Mellitus, Type 1
- Disease Progression
- Female
- Glucose Tolerance Test
- Humans
- Male
- Young Adult
|