ArticleWorld journal of pediatrics : WJP2021
Surrogate markers and predictors of endogenous insulin secretion in children and adolescents with type 1 diabetes.
Article in World journal of pediatrics : WJP, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Efficacy and Safety of an Insulin Patch Pump Compared to Multiple Daily Injections in Pediatric Patients With Diabetes: A Randomized, Open-Label, Crossover, Non-Inferiority Clinical Trial.Clinical medicine insights. Endocrinology and diabetes · 2026Article
- Pubertal stage significantly and independently impacts C-peptide levels at type 1 diabetes diagnosis along with body mass index and age.European journal of pediatrics · 2025Article
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Authors and funding
12 authors.
Funding
Abstract
backgroundNo studies have examined endogenous insulin secretion in pediatric patients with type 1 diabetes in China using the gold-standard mixed-meal tolerance test. Because the latter is labor-intensive, we examined simpler surrogate markers of endogenous insulin secretion in Chinese youth, as previously reported for a European population.
methodsParticipants were 57 children and adolescents with type 1 diabetes aged 4.4-16.8 years (56% females). We performed 120-minute mixed-meal tolerance tests with serum C-peptide (CP) measurements every 30 minutes. Severe insulin deficiency (SID) was defined as CP peak < 0.2 nmol/L. Urine CP and creatinine levels were measured at 0 and 120 minutes.
resultsTwenty-five (44%) patients had SID. Fasting CP levels missed one case (96% sensitivity) with no false positives (100% specificity). While the 120-minute urine CP/creatinine had 100% sensitivity, it yielded markedly lower specificity (63%). Every 1-year increase in diabetes duration and 1-year decrease in age at diagnosis were associated with 37% (P < 0.001) and 20% (P = 0.005) reductions in serum CP area-under-the-curve, respectively. Thus, 86% of children aged < 5 years had SID compared to none among patients aged ≥ 11 years.
conclusionsSimple fasting CP measurements could be used to detect most SID cases in Chinese youth with type 1 diabetes. Fasting CP is a far more reliable measure of endogenous insulin secretion than the more commonly used insulin dose. Therefore, it could more precisely determine insulin secretory capacity to target those who could benefit, if treatments to preserve residual insulin secretion are developed.
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