Skip to main content
Top
Published in: Diabetologia 6/2006

01-06-2006 | Short Communication

Sex- and season-dependent differences in C-peptide levels at diagnosis of immune-mediated type 1 diabetes

Authors: I. Weets, I. Truyen, I. Verschraegen, B. Van der Auwera, J. De Schepper, H. Dorchy, M.-C. Lebrethon, L. Van Gaal, P. Van Rooy, D. G. Pipeleers, F. K. Gorus, Belgian Diabetes Registry

Published in: Diabetologia | Issue 6/2006

Login to get access

Abstract

Aims/hypothesis

The incidence of type 1 diabetes varies according to age, sex and season of diagnosis. We investigated whether these and other clinical, biological and anthropometric parameters were correlated with residual beta cell function in newly diagnosed patients, since it is possible that the nature of external and/or genetic disease accelerators may be (partly) reflected in the inaugural disease presentation.

Materials and methods

The correlates of random C-peptide levels sampled shortly after diagnosis (median [interquartile range]: 3 [0–14] days) were studied by multivariate analysis in 1,883 islet-antibody-positive diabetic patients aged <40 years who were diagnosed between 1989 and 2000.

Results

Higher C-peptide levels (above percentile 50 of patients) were associated with older age at diagnosis, female sex, diagnosis in the high-incidence season (October to March), less-decreased BMI (expressed as a standard deviation score), lower insulin requirements after stabilisation, lower prevalence of ketonuria and a less-increased glycaemia at diagnosis (all p<0.001). C-peptide levels were not correlated with calendar year at diagnosis, duration of symptoms prior to diagnosis, HLA-DQ2/DQ8 genotype or islet antibody status.

Conclusions/interpretation

Sex- and season-dependent differences in residual functional beta cell mass and/or insulin resistance have been identified at diagnosis of type 1 diabetes. They may reflect differences in disease-precipitating external or lifestyle factors and should be further investigated longitudinally in prediabetes to further identify putative aetiological factors, which may provide targets for prevention.
Literature
1.
go back to reference Leslie RDG, Elliott RB (1994) Early environmental events as a cause of IDDM. Evidence and implications. Diabetes 43:843–850PubMedCrossRef Leslie RDG, Elliott RB (1994) Early environmental events as a cause of IDDM. Evidence and implications. Diabetes 43:843–850PubMedCrossRef
2.
go back to reference Soltész G (2003) Diabetes in the young: a paediatric and epidemiological perspective. Diabetologia 46:447–454PubMedCrossRef Soltész G (2003) Diabetes in the young: a paediatric and epidemiological perspective. Diabetologia 46:447–454PubMedCrossRef
4.
go back to reference Weets I, De Leeuw IH, Du Caju MV et al (2002) The incidence of type 1 diabetes in the age group 0–39 years has not increased in Antwerp (Belgium) between 1989 and 2000: evidence for earlier disease manifestation. Diabetes Care 25:840–846PubMedCrossRef Weets I, De Leeuw IH, Du Caju MV et al (2002) The incidence of type 1 diabetes in the age group 0–39 years has not increased in Antwerp (Belgium) between 1989 and 2000: evidence for earlier disease manifestation. Diabetes Care 25:840–846PubMedCrossRef
5.
go back to reference Weets I, Van Autreve J, Van der Auwera BJ et al (2001) Male-to-female excess in diabetes diagnosed in early adulthood is not specific for the immune-mediated form nor is it HLA-DQ restricted: possible relation to increased body mass index. Diabetologia 44:40–47PubMedCrossRef Weets I, Van Autreve J, Van der Auwera BJ et al (2001) Male-to-female excess in diabetes diagnosed in early adulthood is not specific for the immune-mediated form nor is it HLA-DQ restricted: possible relation to increased body mass index. Diabetologia 44:40–47PubMedCrossRef
6.
go back to reference Karjalainen J, Salmela P, Ilonen J, Surcel H-M, Knip M (1989) A comparison of childhood and adult type 1 diabetes mellitus. N Engl J Med 320:881–886 Karjalainen J, Salmela P, Ilonen J, Surcel H-M, Knip M (1989) A comparison of childhood and adult type 1 diabetes mellitus. N Engl J Med 320:881–886
7.
go back to reference Weets I, Kaufman L, Van der Auwera B et al (2004) Seasonality in clinical onset of type 1 diabetes in Belgian patients above age 10 is restricted to HLA-DQ2/DQ8-negative males, which explains the male to female excess in incidence. Diabetologia 47:614–621PubMedCrossRef Weets I, Kaufman L, Van der Auwera B et al (2004) Seasonality in clinical onset of type 1 diabetes in Belgian patients above age 10 is restricted to HLA-DQ2/DQ8-negative males, which explains the male to female excess in incidence. Diabetologia 47:614–621PubMedCrossRef
8.
go back to reference Cole TJ, Freeman JV, Preece MA (1995) Body mass index reference curves for the UK, 1990. Arch Dis Child 73:25–29PubMedCrossRef Cole TJ, Freeman JV, Preece MA (1995) Body mass index reference curves for the UK, 1990. Arch Dis Child 73:25–29PubMedCrossRef
9.
go back to reference Decochez K, De Leeuw IH, Keymeulen B et al (2002) IA-2 autoantibodies predict impending type 1 diabetes in siblings of patients. Diabetologia 45:1658–1666PubMedCrossRef Decochez K, De Leeuw IH, Keymeulen B et al (2002) IA-2 autoantibodies predict impending type 1 diabetes in siblings of patients. Diabetologia 45:1658–1666PubMedCrossRef
10.
go back to reference Weets I, Siraux V, Daubresse JC et al (2002) Relation between disease phenotype and HLA-DQ genotype in diabetic patients diagnosed in early adulthood. J Clin Endocrinol Metab 87:2597–2605PubMedCrossRef Weets I, Siraux V, Daubresse JC et al (2002) Relation between disease phenotype and HLA-DQ genotype in diabetic patients diagnosed in early adulthood. J Clin Endocrinol Metab 87:2597–2605PubMedCrossRef
11.
go back to reference Pozzilli P, Mesturino CA, Crino A et al (2001) Is the process of beta-cell destruction in type 1 diabetes at time of diagnosis more extensive in females than in males? Eur J Endocrinol 145:757–761PubMedCrossRef Pozzilli P, Mesturino CA, Crino A et al (2001) Is the process of beta-cell destruction in type 1 diabetes at time of diagnosis more extensive in females than in males? Eur J Endocrinol 145:757–761PubMedCrossRef
12.
go back to reference Ludvigsson J, Afoke AO (1989) Seasonality of type 1 (insulin-dependent) diabetes mellitus: values of C-peptide, insulin antibodies and haemoglobin A1c show evidence of a more rapid loss of insulin secretion in epidemic patients. Diabetologia 32:84–91PubMedCrossRef Ludvigsson J, Afoke AO (1989) Seasonality of type 1 (insulin-dependent) diabetes mellitus: values of C-peptide, insulin antibodies and haemoglobin A1c show evidence of a more rapid loss of insulin secretion in epidemic patients. Diabetologia 32:84–91PubMedCrossRef
13.
go back to reference Fahlen M, Oden A, Bjorntorp P, Tibblin G (1971) Seasonal influence on insulin secretion in man. Clin Sci 41:453–458PubMed Fahlen M, Oden A, Bjorntorp P, Tibblin G (1971) Seasonal influence on insulin secretion in man. Clin Sci 41:453–458PubMed
14.
go back to reference Veijola R, Knip M, Reijonen H, Vahasalo P, Puukka R, Ilonen J (1995) Effect of genetic risk load defined by HLA-DQB1 polymorphism on clinical characteristics of IDDM in children. Eur J Clin Invest 25:106–112PubMedCrossRef Veijola R, Knip M, Reijonen H, Vahasalo P, Puukka R, Ilonen J (1995) Effect of genetic risk load defined by HLA-DQB1 polymorphism on clinical characteristics of IDDM in children. Eur J Clin Invest 25:106–112PubMedCrossRef
15.
go back to reference Service FJ, O’Brien PC, Kao PC, Young FWJR (1992)C-peptide suppression test: effects of gender, age and body mass index; implications for the diagnosis of insulinoma. J Clin Endocrinol Metab 74:204–210PubMedCrossRef Service FJ, O’Brien PC, Kao PC, Young FWJR (1992)C-peptide suppression test: effects of gender, age and body mass index; implications for the diagnosis of insulinoma. J Clin Endocrinol Metab 74:204–210PubMedCrossRef
Metadata
Title
Sex- and season-dependent differences in C-peptide levels at diagnosis of immune-mediated type 1 diabetes
Authors
I. Weets
I. Truyen
I. Verschraegen
B. Van der Auwera
J. De Schepper
H. Dorchy
M.-C. Lebrethon
L. Van Gaal
P. Van Rooy
D. G. Pipeleers
F. K. Gorus
Belgian Diabetes Registry
Publication date
01-06-2006
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 6/2006
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-006-0191-x

Other articles of this Issue 6/2006

Diabetologia 6/2006 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine