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Proinsulin, GLP-1, and glucagon are associated with partial remission in children and adolescents with newly diagnosed type 1 diabetes
Department of Paediatrics, Glostrup/Herlev University Hospital, Copenhagen, Denmark.
Department of Paediatrics, Glostrup/Herlev University Hospital, Copenhagen, Denmark.
Department of Paediatrics, Glostrup/Herlev University Hospital, Copenhagen, Denmark.
Department of Statistics, University of Southern Denmark, Odense, Denmark.
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2012 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 13, no 1, 51-58 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Proinsulin is a marker of beta-cell distress and dysfunction in type 2 diabetes and transplanted islets. Proinsulin levels are elevated in patients newly diagnosed with type 1 diabetes. Our aim was to assess the relationship between proinsulin, insulin dose-adjusted haemoglobin A1c (IDAA1C), glucagon-like peptide-1 (GLP-1), glucagon, and remission status the first year after diagnosis of type 1 diabetes.

Methods: Juvenile patients (n = 275) were followed 1, 6, and 12 months after diagnosis. At each visit, partial remission was defined as IDAA1C = 9%. The patients had a liquid meal test at the 1-, 6-, and 12-month visits, which included measurement of C-peptide, proinsulin, GLP-1, glucagon, and insulin antibodies (IA).

Results: Patients in remission at 6 and 12 months had significantly higher levels of proinsulin compared to non-remitting patients (p < 0.0001, p = 0.0002). An inverse association between proinsulin and IDAA1C was found at 1 and 6 months (p = 0.0008, p = 0.0022). Proinsulin was positively associated with C-peptide (p < 0.0001) and IA (p = 0.0024, p = 0.0068, p < 0.0001) at 1, 6, and 12 months. Glucagon (p < 0.0001 and p < 0.02) as well as GLP-1 (p = 0.0001 and p = 0.002) were significantly lower in remitters than in non-remitters at 6 and 12 months. Proinsulin associated positively with GLP-1 at 1 month (p = 0.004) and negatively at 6 (p = 0.002) and 12 months (p = 0.0002).

Conclusions: In type 1 diabetes, patients in partial remission have higher levels of proinsulin together with lower levels of GLP-1 and glucagon compared to patients not in remission. In new onset type 1 diabetes proinsulin level may be a sign of better residual beta-cell function.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2012. Vol. 13, no 1, 51-58 p.
Keyword [en]
GLP-1, glucagon, proinsulin, type 1 diabetes, remission phase
National Category
Endocrinology and Diabetes Pediatrics
Identifiers
URN: urn:nbn:se:oru:diva-58707DOI: 10.1111/j.1399-5448.2011.00812.xISI: 000299549900009PubMedID: 22118630Scopus ID: 2-s2.0-84856405133OAI: oai:DiVA.org:oru-58707DiVA: diva2:1127731
Available from: 2017-07-18 Created: 2017-07-18 Last updated: 2017-09-13Bibliographically approved

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