Prognosis for residual islet β‐cell secretion function in young patients with newly diagnosed type 1 diabetes

作者：Haitao Miao, Juanjuan Zhang, Bin Gu, Aibo Gao, Jie Hong, Yifei Zhang, Weiqiong Gu · 发表于：Journal of Diabetes · 年份：2019 · DOI：10.1111/1753-0407.12912 · 被引用次数：5 · 研究领域：Diabetes and associated disorders、Pancreatic function and diabetes、Diabetes Management and Research

BACKGROUND: This study investigated possible predictors of residual islet β-cell function (RBF) in young patients with newly diagnosed type 1 diabetes (T1D). METHODS: After analyzing RBF in 443 patients with T1D according to age at diagnosis and disease duration, 110 were followed-up over 18-60 months. A nomogram was developed by logistic regression to explore factors associated with long-term RBF. RESULTS: Of the 443 T1D patients (mean [±SD] age 20.28 ± 5.50 years; mean [±SD] diabetes duration 28.5 ± 14.6 months), RBF was preserved in 64.3%. Independent predictors for poor RBF outcome among the 110 patients in the follow-up cohort were age at onset (odds ratio [OR] 0.82; 95% confidence interval [CI] 0.73-0.92; P < 0.001), high-risk human leukocyte antigen (HLA) status (OR 4.73; CI 1.28-17.52; P = 0.020), female sex (OR 3.39; CI 1.03-11.22; P = 0.045), and a history of diabetic ketoacidosis (DKA; OR 8.71; CI 2.31-32.83; P < 0.001). Baseline glutamic acid decarboxylase (GAD) antibody, family history of diabetes, body mass index, insulin dosage, and C-peptide and HbA1c levels were not associated with poor RBF outcome. Intensive glycemic control after T1D diagnosis may improve RBF within a mean (±SD) follow-up of 35.1 ± 13.8 months. The calibration plot for the probability of 2-, 3-, and 4-year RBF showed optimal agreement between nomogram-predicted and actual observed probabilities. CONCLUSIONS: Younger age of onset, female sex, higher HLA risk status, and a history of DKA were...