C-peptide in the classification of diabetes in children and adolescents.

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title = "C-peptide in the classification of diabetes in children and adolescents.",
abstract = "C-peptide in the classification of diabetes in children and adolescents. Aim: To report C-peptide results in newly diagnosed patients and the relation to clinical diagnosis of diabetes. Methods: A nation-wide cohort, the Better Diabetes Diagnosis study was used to determine serum C-peptide at diagnosis in 2734 children and adolescents. Clinical data were collected at diagnosis and follow-up. C-peptide was determined in a validated and controlled time-resolved fluoroimmunoassay. Results: The clinical classification of diabetes, before any information on human leukocyte antigen, islet autoantibodies, or C-peptide was received, was type 1 diabetes (T1D) in 93%, type 2 diabetes (T2D) in 1.9%, maturity onset diabetes of the young (MODY) in 0.8%, secondary diabetes (0.6%), while 3.3% could not be classified. In a random, non-fasting serum sample at diagnosis, 56% of the patients had a C-peptide value >0.2 nmol/L. Children classified as T2D had the highest mean C-peptide (1.83 + 1.23 nmol/L) followed by MODY (1.04 ± 0.71 nmol/L) and T1D (0.28 ± 0.25 nmol/L). Only 1/1037 children who had C-peptide <0.2 nmol/L at diagnosis was classified with a type of diabetes other than T1D. Predictive value of C-peptide >1.0 nmol/L for the classification of either T2D or MODY was 0.46 [confidence interval 0.37-0.58]. Conclusions: More than half of children with newly diagnosed diabetes have clinically important residual beta-cell function. As the clinical diagnosis is not always straightforward, a random C-peptide taken at diagnosis may help to classify diabetes. There is an obvious use for C-peptide determinations to evaluate beta-cell function in children with diabetes.",
author = "Johnny Ludvigsson and Annelie Carlsson and G Forsander and Sten Ivarsson and I Kockum and {\AA}ke Lernmark and Bengt Lindblad and C Marcus and U Samuelsson",
year = "2012",
doi = "10.1111/j.1399-5448.2011.00807.x",
language = "English",
volume = "13",
pages = "45--50",
journal = "Pediatric Diabetes",
issn = "1399-543X",
publisher = "Wiley-Blackwell",