Study finds type 1 diabetics don’t always lose ability to produce insulin

by Barbara Hewitt on December 25, 2014

People with type 1 diabetes do not necessarily lose all ability to produce insulin and now new research is looking at how this could be used to improve lives.

It is estimated that about a third of people with type 1 diabetes produce insulin, as measured by C-peptide, a by-product of insulin production, even 40 years after being diagnosed with the condition.


About a third of people with type 1 diabetes produce insulin, as measured by C-peptide

The research from T1D Exchange, a consortium of diabetes centres, sheds new light on the long accepted belief that these patients lose all ability to produce any insulin. Scientists believe this could have significant implications.

Using samples from the T1D Exchange Biobank, a repository of type 1 diabetes biological samples, the study confirmed that C-peptide is present in patients across a wide age spectrum, with greater frequency and higher values in those diagnosed as adults as compared with those diagnosed as children.

The findings provide clinicians proof that residual insulin production can be anticipated in this population, thereby potentially decreasing the risk of misdiagnosis as the more common type 2 diabetes and increasing opportunities for improved treatments to control glucose levels.

The data suggests important differences in the biological process of type 1 diabetes between those diagnosed as children or as adults, according to Asa Davis, T1D Exchange programme manager at Benaroya Research Institute, which houses the TID Exchange Biobank.

“These findings lend further credence to research underway on targeted therapies that could prolong insulin production, helping type 1 diabetes patients better manage their disease and reduce complications,” said Davis.

“For example, potential immunotherapy treatments are already being studied with this goal in mind, and our findings underscore that those diagnosed at a young age may be more likely to benefit from such new approaches,” Davis added.

The researchers measured C-peptide levels in 919 people with type 1 diabetes, ranging from three to 80 years from diagnosis and from age five to 88, at 28 of T1D Exchange’s 70 Clinic Network locations.

Among the participants with three- to five-year disease duration, C-peptide was present in 78% of patients diagnosed after age 18, and in 46% of those diagnosed before the age of 18.
And 16% of adult onset type 1 individuals and 6% of childhood onset type 1 diabetes cases had residual C-peptide more than 40 years from diagnosis.

“Other studies have shown that some type 1 diabetes patients who have lived with the disease for many years continue to secrete insulin and the assumption has been that these patients are exceptional,” said senior author Carla Greenbaum, director of the T1D Exchange Biobank Operations Centre at the Benaroya Research Institute.

“For the first time, we can definitively say that these patients are a true subset of the type 1 diabetes population, which has major clinical and health policy implications,” she explained.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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