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

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C-peptide in the classification of diabetes in children and adolescents. / Ludvigsson, Johnny; Carlsson, Annelie; Forsander, G; Ivarsson, Sten; Kockum, I; Lernmark, Åke; Lindblad, Bengt; Marcus, C; Samuelsson, U.

In: Pediatric Diabetes, Vol. 13, 2012, p. 45-50.

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Ludvigsson, Johnny ; Carlsson, Annelie ; Forsander, G ; Ivarsson, Sten ; Kockum, I ; Lernmark, Åke ; Lindblad, Bengt ; Marcus, C ; Samuelsson, U. / C-peptide in the classification of diabetes in children and adolescents. In: Pediatric Diabetes. 2012 ; Vol. 13. pp. 45-50.

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TY - JOUR

T1 - C-peptide in the classification of diabetes in children and adolescents.

AU - Ludvigsson, Johnny

AU - Carlsson, Annelie

AU - Forsander, G

AU - Ivarsson, Sten

AU - Kockum, I

AU - Lernmark, Åke

AU - Lindblad, Bengt

AU - Marcus, C

AU - Samuelsson, U

PY - 2012

Y1 - 2012

N2 - 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.

AB - 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.

U2 - 10.1111/j.1399-5448.2011.00807.x

DO - 10.1111/j.1399-5448.2011.00807.x

M3 - Article

C2 - 21910810

VL - 13

SP - 45

EP - 50

JO - Pediatric Diabetes

JF - Pediatric Diabetes

SN - 1399-543X

ER -