Journal article
Lack of Association Between Residual Insulin Production and Glucagon Response to Hypoglycemia in Youth With Short Duration of Type 1 Diabetes
Diabetes care, Vol.36(6), pp.1470-1476
2013
DOI: 10.2337/dc12-1697
PMCID: PMC3661789
PMID: 23288858
Abstract
OBJECTIVE To examine the loss of glucagon response to hypoglycemia and its relationship with residual β-cell function early in the course of type 1 diabetes (T1D) in youth.
RESEARCH DESIGN AND METHODS Twenty-one youth with T1D duration <1 year (ages 8–18 years, T1D duration 6–52 weeks) underwent mixed-meal tolerance tests (MMTTs) to assess residual β-cell function and hypoglycemic clamps to assess glucagon responses to hypoglycemia. Glucagon responses to hypoglycemia in T1D subjects were compared with those in 12 nondiabetic young adults (ages 19–25 years).
RESULTS Peak MMTT-stimulated C-peptide levels (range 0.12–1.43) were ≥0.2 nmol/L in all but one T1D subject. As expected, the median of glucagon responses to hypoglycemia in the T1D subjects (18 pg/mL [interquartile range 7–32]) was significantly reduced compared with the responses in nondiabetic control subjects (38 pg/mL [19–66], P = 0.02). However, there was no correlation between the incremental increase in plasma glucagon during the hypoglycemic clamp and the incremental increase and peak plasma C-peptide level during the MMTT. Similarly, the seven T1D subjects who failed to achieve an increase in glucagon ≥12 pg/mL (i.e., 3 SD above baseline values) had C-peptide response ≥0.2 nmol/L (0.54–1.12), and the one T1D subject with peak stimulated <0.2 nmol/L had a 14 pg/mL increase in plasma glucagon in response to hypoglycemia.
CONCLUSIONS Impaired plasma glucagon responses to hypoglycemia are evident in youth with T1D during the first year of the disease. Moreover, defective and absent glucagon responses to hypoglycemia were observed in patients who retained clinically important residual endogenous β-cell function.
Details
- Title: Subtitle
- Lack of Association Between Residual Insulin Production and Glucagon Response to Hypoglycemia in Youth With Short Duration of Type 1 Diabetes
- Creators
- Jennifer SHERR - Pediatric Endocrinology, Yale University, New Haven, Connecticut, United StatesDongyuan XING - Jaeb Center for Health Research, Tampa, Florida, United StatesAna Maria ARBELAEZ - Department of Pediatrics, Washington University, St. Louis, Missouri, United StatesWilliam V TAMBORLANE - Pediatric Endocrinology, Yale University, New Haven, Connecticut, United StatesKatrina J RUEDY - Jaeb Center for Health Research, Tampa, Florida, United StatesRoy W BECK - Jaeb Center for Health Research, Tampa, Florida, United StatesCraig KOLLMAN - Jaeb Center for Health Research, Tampa, Florida, United StatesBruce BUCKINGHAM - Pediatric Endocrinology, Stanford University, Stanford, California, United StatesNeil H WHITE - Department of Pediatrics, Washington University, St. Louis, Missouri, United StatesLarry FOX - Pediatric Endocrinology, Nemours Children's Clinic, Jacksonville, Florida, United StatesEva TSALIKIAN - Pediatric Endocrinology, University of Iowa, Iowa City, Iowa, United StatesStuart WEINZIMER - Pediatric Endocrinology, Yale University, New Haven, Connecticut, United StatesDiabetes in Children Network (DirecNet)
- Resource Type
- Journal article
- Publication Details
- Diabetes care, Vol.36(6), pp.1470-1476
- DOI
- 10.2337/dc12-1697
- PMID
- 23288858
- PMCID
- PMC3661789
- NLM abbreviation
- Diabetes Care
- ISSN
- 0149-5992
- eISSN
- 1935-5548
- Publisher
- American Diabetes Association
- Language
- English
- Date published
- 2013
- Academic Unit
- Stead Family Department of Pediatrics; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984093508002771
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