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The rise and fall of insulin secretion in type 1 diabetes mellitus

Tsai, E. ; Sherry, N. ; Palmer, J. ; Herold, K.

Diabetologia, 2006, Vol.49(2), pp.261-270 [Periódico revisado por pares]

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  • Título:
    The rise and fall of insulin secretion in type 1 diabetes mellitus
  • Autor: Tsai, E. ; Sherry, N. ; Palmer, J. ; Herold, K.
  • Assuntos: Autoimmunity ; C-peptide ; Insulin secretion ; Natural history ; Type 1 diabetes
  • É parte de: Diabetologia, 2006, Vol.49(2), pp.261-270
  • Descrição: An understanding of the natural history of beta cell responses is an essential prerequisite for interventional studies designed to prevent or treat type 1 diabetes. Here we review published data on changes in insulin responses in humans with type 1 diabetes. We also describe a new analysis of C-peptide responses in subjects who are at risk of type 1 diabetes and enrolled in the Diabetes Prevention Trial-1 (DPT-1). C-peptide responses to a mixed meal increase during childhood and through adolescence, but show no significant change during adult life; responses are lower in adults who progress to diabetes than in those who do not. The age-related increase in C-peptide responses may account for the higher levels of C-peptide observed in adults with newly diagnosed type 1 diabetes compared withhose in children and adolescents. Based on these findings, we propose a revised model of the natural history of the disease, in which an age-related increase in functional beta cell responses before the onset of autoimmune beta cell damage is an important determinant of the clinical features of the disease.
  • Idioma: Inglês

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