Faculty Collaboration Database

The Effect of Ethnicity in the Rate of Beta-Cell Functional Loss in the First 3 Years After Type 1 Diabetes Diagnosis. J Clin Endocrinol Metab 2020 Dec 01;105(12):e4393-406

Date

06/06/2020

Pubmed ID

32502242

Pubmed Central ID

PMC7531906

DOI

10.1210/clinem/dgaa348

Scopus ID

2-s2.0-85092679889 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

OBJECTIVE: We set forth to compare ethnicities for metabolic and immunological characteristics at the clinical diagnosis of type 1 diabetes (T1D) and assess the effect of ethnicity on beta-cell functional loss within 3 years after clinical diagnosis.

RESEARCH METHODS AND DESIGN: We studied participants in TrialNet New Onset Intervention Trials (n = 624, median age = 14.4 years, 58% male, 8.7% Hispanic) and followed them prospectively for 3 years. Mixed meal tolerance tests (MMTT) were performed within 6 months following clinical diagnosis and repeated semiannually. Unless otherwise indicated, analyses were adjusted for age, sex, BMI Z-score, and diabetes duration.

RESULTS: At T1D clinical diagnosis, Hispanics, compared with non-Hispanic whites (NHW), had a higher frequency of diabetic ketoacidosis (DKA) (44.7% vs 25.3%, OR = 2.36, P = 0.01), lower fasting glucose (97 vs 109 mg/dL, P = 0.02) and higher fasting C-peptide (1.23 vs 0.94 ng/mL, P = 0.02) on the first MMTT, and higher frequency of ZnT8 autoantibody positivity (n = 201, 94.1% vs 64%, OR = 7.98, P = 0.05). After exclusion of participants in experimental arms of positive clinical trials, C-peptide area under the curve (AUC) trajectories during the first 3 years after clinical diagnosis were not significantly different between Hispanics and NHW after adjusting for age, sex, BMI-z score, and DKA (n = 413, P = 0.14).

CONCLUSION: Despite differences in the metabolic and immunological characteristics at clinical diagnosis of T1D between Hispanics and NHW, C-peptide trajectories did not differ significantly in the first 3 years following clinical diagnosis after adjustment for body mass index and other confounders. These findings may inform the design of observational studies and intervention trials in T1D.

Author List

Tosur M, Cleves MA, Sosenko JM, Libman I, Baidal DA, Balasubramanyam A, Redondo MJ, Type 1 Diabetes TrialNet Study Group

Author

Rosanna V. Fiallo-Scharer MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
C-Peptide
Diabetes Mellitus, Type 1
Female
Humans
Insulin-Secreting Cells
Male
Prospective Studies