Diabetes Prevention Trial–Type 1

Abstract

OBJECTIVE — We examined metabolic changes in the period immediately after the diagnosis of type 1 diabetes and in the period leading up to its diagnosis in Diabetes Prevention Trial–Type 1 (DPT-1) participants. RESEARCH DESIGN AND METHODS — The study included oral insulin trial participants and parenteral insulin trial control subjects (n � 63) in whom diabetes was diagnosed by a 2-h diabetic oral glucose tolerance test (OGTT) that was confirmed by another diabetic OGTT within 3 months. Differences in glucose and C-peptide levels between the OGTTs were assessed. RESULTS — Glucose levels increased at 90 (P � 0.006) and 120 min (P � 0.001) from the initial diabetic OGTT to the confirmatory diabetic OGTT (mean � SD interval 5.5 � 2.8 weeks). Peak C-peptide levels fell substantially between the OGTTs (median change �14.3%, P � 0.001). Among the 55 individuals whose last nondiabetic OGTT was �6 months before the initial diabetic OGTT, peak C-peptide levels decreased between these two OGTTs (median change �14.0%, P � 0.052). Among those same individuals the median change in peak C-peptide levels from the last normal OGTT to the confirmatory OGTT (interval 7.5 � 1.3 months) was �23.8 % (P � 0.001). Median rates of change in peak C-peptide levels were 0.00 ng � ml �1

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