The clinical development of type 1 diabetes (Stage 3 T1D) is preceded by a presymptomatic period marked by numerous islet autoantibodies and normal glucose tolerance (Stage 1 T1D). The goal of the study was to compare the metabolic phenotypes of -cell function, insulin sensitivity, and clearance in normoglycemic youth with Stage 1 T1D to healthy unrelated peers during a 3-hour oral glucose tolerance test (OGTT). Twenty-eight lean adolescents, 14 with 2 islet autoantibodies (cases) and 14 healthy controls, completed a 3-hour 9-point OGTT with glucose, C-peptide, and insulin measurements. The oral minimum model was utilised to quantify -cell responsiveness (total) and insulin sensitivity (SI), allowing the disposition index (DI=totalSI) to be used to measure -cell function. Participants with impaired fasting glucose, impaired glucose tolerance, or OGTT glucose concentrations more than 200 mg/dL were excluded. When compared to controls, cases had lower DI due to a simultaneous decrease in both total and SI. Cases had lower CL0 and CL180 values than controls.
Presymptomatic Stage 1 T1D in children is linked with decreased insulin sensitivity and -cell responsiveness, as well as impaired insulin clearance.
Reference: https://academic.oup.com/jcem/article-abstract/106/9/2660/6277046?redirectedFrom=fulltext
