liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Lessons From the Mixed-Meal Tolerance Test Use of 90-minute and fasting C-peptide in pediatric diabetes
University of Exeter, England .
University of Exeter, England .
Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
University of Exeter, England .
Show others and affiliations
2013 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 36, no 2, 195-201 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE-Mixed-meal tolerance test (MMTT) area under the curve C-peptide (AUC CP) is the gold-standard measure of endogenous insulin secretion in type 1 diabetes but is intensive and invasive to perform. The 90-minMMTT-stimulated CP andgt;= 0.2 nmol/L (90CP) is related to improved clinical outcomes, and CP andgt;= 0.1 nmol/L is the equivalent fasting measure (FCP). We assessed whether 90CP or FCP are alternatives to a full MMTT. less thanbrgreater than less thanbrgreater thanRESEARCH DESIGN AND METHODS-CP was measured during 1,334 MMTTs in 421 type 1 diabetes patients aged, 18 years at 3, 9, 18, 48, and 72 months duration. We assessed: 1) correlation between mean AUC CP and 90CP or FCP; 2) sensitivity and specificity of 90CP andgt;= 0.2 nmol/L and FCP andgt;= 0.1 nmol/L to detect peak CP andgt;= 0.2 nmol/L and the equivalent AUC CP; and 3) how the time taken to reach the CP peak varied with age of diagnosis and diabetes duration. less thanbrgreater than less thanbrgreater thanRESULTS-AUC CP was highly correlated to 90CP (r(s) = 0.96; P andlt; 0.0001) and strongly correlated to FCP (r(s) = 0.84; P andlt; 0.0001). AUC CP andgt;= 23 nmol/L/150 min was the equivalent cutoff for peak CP andgt;= 0.2 nmol/L (98% sensitivity/97% specificity). A 90CP andgt;= 0.2 nmol/L correctly classified 96% patients using AUC or peak CP, whereas FCP andgt;= 0.1 nmol/L classified 83 and 85% patients, respectively. There was only a small difference seen between peak and 90CP (median 0.02 nmol/L). The CP peak occurred earlier in patients with longer diabetes duration (6.1 min each 1-year increase in duration) and younger age (2.5 min each 1-year increase). less thanbrgreater than less thanbrgreater thanCONCLUSIONS-90CP is a highly sensitive and specific measure of AUC and peak CP in children and adolescents with type 1 diabetes and offers a practical alternative to a full MMTT. Diabetes Care 36:195-201, 2013

Place, publisher, year, edition, pages
American Diabetes Association , 2013. Vol. 36, no 2, 195-201 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-90076DOI: 10.2337/dc12-0836ISI: 000314467100013OAI: diva2:612423

Funding Agencies|Diabetes UK||Barndiabetesfonden (The Swedish Child Diabetes Foundation)||Swedish Research Council||Peninsula NIHR Clinical Research Facility||

Available from: 2013-03-21 Created: 2013-03-19 Last updated: 2014-11-12

Open Access in DiVA

fulltext(961 kB)101 downloads
File information
File name FULLTEXT01.pdfFile size 961 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Casas, RosauraLudvigsson, Johnny
By organisation
PediatricsFaculty of Health SciencesDepartment of Paediatrics in Linköping
In the same journal
Diabetes Care
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 101 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 193 hits
ReferencesLink to record
Permanent link

Direct link