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Diabetologia
Published in: Diabetologia 2/2006

01-02-2006 | Review

The rise and fall of insulin secretion in type 1 diabetes mellitus

Authors: E. B. Tsai, N. A. Sherry, J. P. Palmer, K. C. Herold, for the DPT-1 Study Group

Published in: Diabetologia | Issue 2/2006

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Abstract

An understanding of the natural history of beta cell responses is an essential prerequisite for interventional studies designed to prevent or treat type 1 diabetes. Here we review published data on changes in insulin responses in humans with type 1 diabetes. We also describe a new analysis of C-peptide responses in subjects who are at risk of type 1 diabetes and enrolled in the Diabetes Prevention Trial-1 (DPT-1). C-peptide responses to a mixed meal increase during childhood and through adolescence, but show no significant change during adult life; responses are lower in adults who progress to diabetes than in those who do not. The age-related increase in C-peptide responses may account for the higher levels of C-peptide observed in adults with newly diagnosed type 1 diabetes compared withhose in children and adolescents. Based on these findings, we propose a revised model of the natural history of the disease, in which an age-related increase in functional beta cell responses before the onset of autoimmune beta cell damage is an important determinant of the clinical features of the disease.
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Metadata
Title
The rise and fall of insulin secretion in type 1 diabetes mellitus
Authors
E. B. Tsai
N. A. Sherry
J. P. Palmer
K. C. Herold
for the DPT-1 Study Group
Publication date
01-02-2006
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 2/2006
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-005-0100-8

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