ArticleDiabetes care2020
C-Peptide Levels in Subjects Followed Longitudinally Before and After Type 1 Diabetes Diagnosis in TrialNet.
Article in Diabetes care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 67 citations in OpenAlex.
- Imatinib therapy for patients with recent-onset type 1 diabetes: a multicentre, randomised, double-blind, placebo-controlled, phase 2 trial.The lancet. Diabetes & endocrinology · 2021Trial
- Teplizumab improves and stabilizes beta cell function in antibody-positive high-risk individuals.Science translational medicine · 2021Trial
- C-Peptide Provides Critical Contextual Insight Into Elevated Glucose Values During Progression to Type 1 Diabetes.Diabetes care · 2026Review
- Biomarkers of partial remission in paediatric type 1 diabetes: β-cell stress, immune-metabolic remodelling, and translational priorities-a narrative review.Translational pediatrics · 2026Review
- Development and application of type 1 diabetes polygenic scores across diverse populations.Diabetologia · 2026Review
- Low-Dose Antithymocyte Globulin in Type 1 Diabetes: Real-World Exploratory Observation of C-Peptide by Modified Quantitative Response (mQR).Diabetes care · 2026Article
- New and emerging therapies in type 1 diabetes mellitus.The Journal of clinical investigation · 2026Review
- Relevance of Quantitative Measures of Beta-Cell Function in Clinical Practice.Hormone research in paediatrics · 2026Review
- 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Induction of immune education in type 1 diabetes through controlled allogeneic islet rejection at onset: a monocentric open-label pilot study.EClinicalMedicine · 2025Article
- An Antibody Cocktail-Based Immunoaffinity-LC-MS Method Enabled Ultra-Sensitive and Robust Quantification of Circulating Proinsulin Proteoforms and C-Peptide.Analytical chemistry · 2025Article
- Review
- Call for Standardization of C-Peptide Measurement.Journal of diabetes science and technology · 2025Review
- The pathophysiology, presentation and classification of Type 1 diabetes.Diabetes, obesity & metabolism · 2025Review
- M120 Risk Score Improves Identification of Children at High Risk of Developing Clinical Type 1 Diabetes and Reports Short-term Response to Preventive Immunotherapy.Diabetes care · 2025Article
- Type 1 Diabetes TrialNet: Leading the Charge in Disease Prediction, Prevention, and Immunotherapeutic Mechanistic Understanding.Diabetes care · 2025Review
- Distribution of glutathione peroxidase-1 immunoreactive cells in pancreatic islets from type 1 diabetic donors and non-diabetic donors with and without islet cell autoantibodies is variable and independent of disease.Cell and tissue research · 2025Article
- Repeated OGTT Versus Continuous Glucose Monitoring for Predicting Development of Stage 3 Type 1 Diabetes: A Longitudinal Analysis.Diabetes care · 2025Article
- Current perspectives and the future of disease-modifying therapies in type 1 diabetes.World journal of diabetes · 2025Article
- Emerging Concepts and Success Stories in Type 1 Diabetes Research: A Road Map for a Bright Future.Diabetes · 2025Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveInsulin secretion declines rapidly after diagnosis of type 1 diabetes, followed by a slower rate of change. Previous studies have demonstrated that the C-peptide decline begins before the clinical diagnosis. Changes in insulin secretion in the same individuals studied from preclinical stages through and after clinical diagnosis have not been previously reported. RESEARCH DESIGN AND
methodsAntibody-positive relatives undergo sequential oral glucose tolerance testing (OGTT) as part of TrialNet's Pathway to Prevention study and continue both OGTT and mixed-meal tolerance testing (MMTT) as part of the Long-term Investigational Follow-up in TrialNet study if they develop type 1 diabetes. We analyzed glucose and C-peptide data obtained from 80 TrialNet subjects who had OGTT before and after clinical diagnosis. Separately, we compared C-peptide response to OGTT and MMTT in 127 participants after diagnosis.
resultsC-peptide did not change significantly until 6 months before the clinical diagnosis of type 1 diabetes and continued to decline postdiagnosis, and the rates of decline for the first 6 months postdiagnosis were similar to the 6 months prediagnosis. There were no significant differences in MMTT and OGTT C-peptide responses in paired tests postdiagnosis.
conclusionsThis is the first analysis of C-peptide levels in longitudinally monitored patients with type 1 diabetes studied from before diagnosis and continuing to the postdiagnosis period. These data highlight the discordant timing between accelerated β-cell dysfunction and the current glucose thresholds for clinical diagnosis. To preserve β-cell function, disease-modifying therapy should start at or before the acute decline in C-peptide.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.