Age-dependent decline of β-cell function in type 1 diabetes after diagnosis: A multi-centre longitudinal study

A. Barker, A. Lauria, N. Schloot, N. Hosszufalusi, J. Ludvigsson, C. Mathieu, D. Mauricio, M. Nordwall, B. Van der Schueren, T. Mandrup-Poulsen, W. A. Scherbaum, I. Weets, F. K. Gorus, N. Wareham, R. D. Leslie, P. Pozzilli

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Aims: C-peptide secretion is currently the only available clinical biomarker to measure residual β-cell function in type 1 diabetes. However, the natural history of C-peptide decline after diagnosis can vary considerably dependent upon several variables. We investigated the shape of C-peptide decline over time from type 1 diabetes onset in relation to age at diagnosis, haemoglobin A1c (HbA1c) levels and insulin dose. Methods: We analysed data from 3929 type 1 diabetes patients recruited from seven European centres representing all age groups at disease onset (childhood, adolescence and adulthood). The influence of the age at onset on β-cell function was investigated in a longitudinal analysis at diagnosis and up to 5-years follow-up. Results: Fasting C-peptide (FCP) data at diagnosis were available in 3668 patients stratified according to age at diagnosis in four groups (<5years, n=344; >5years<10years, n=668; >10years<18years, n=991; >18years, n=1655). FCP levels were positively correlated with age (p<0.001); the subsequent decline in FCP over time was log-linear with a greater decline rate in younger age groups (p<0.0001). Conclusions: This study reveals a positive correlation between age at diagnosis of type 1 diabetes and FCP with a more rapid decline of β-cell function in the very young patients. These data can inform the design of clinical trials using C-peptide values as an end-point for the effect of a given treatment.

Original languageEnglish
Pages (from-to)262-267
Number of pages6
JournalDiabetes, Obesity and Metabolism
Issue number3
Publication statusPublished - Mar 2014



  • Clinical trial
  • Type 1 diabetes
  • β cell

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Barker, A., Lauria, A., Schloot, N., Hosszufalusi, N., Ludvigsson, J., Mathieu, C., Mauricio, D., Nordwall, M., Van der Schueren, B., Mandrup-Poulsen, T., Scherbaum, W. A., Weets, I., Gorus, F. K., Wareham, N., Leslie, R. D., & Pozzilli, P. (2014). Age-dependent decline of β-cell function in type 1 diabetes after diagnosis: A multi-centre longitudinal study. Diabetes, Obesity and Metabolism, 16(3), 262-267.