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Tosur, Mustafa; Cleves, Mario A; Sosenko, Jay M; Libman, Ingrid; Baidal, David A; Balasubramanyam, Ashok; Redondo, Maria J; Greenbaum, C J; Anderson, M; Antinozzi, P; Atkinson, M; Battaglia, M; Becker, D; Bingley, P; Bosi, E; Buckner, J; Colman, P; DiMeglio, L; Gitelman, S; Goland, R; Gottlieb, P; Herold, K; Insel, R; Kay, T; [...]

The Effect of Ethnicity in the Rate of Beta-Cell Functional Loss in the First 3 Years After Type 1 Diabetes Diagnosis

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  • Media type: E-Article
  • Title: The Effect of Ethnicity in the Rate of Beta-Cell Functional Loss in the First 3 Years After Type 1 Diabetes Diagnosis
  • Contributor: Tosur, Mustafa; Cleves, Mario A; Sosenko, Jay M; Libman, Ingrid; Baidal, David A; Balasubramanyam, Ashok; Redondo, Maria J; Greenbaum, C J; Anderson, M; Antinozzi, P; Atkinson, M; Battaglia, M; Becker, D; Bingley, P; Bosi, E; Buckner, J; Colman, P; DiMeglio, L; Gitelman, S; Goland, R; Gottlieb, P; Herold, K; Insel, R; Kay, T; [...]
  • imprint: The Endocrine Society, 2020
  • Published in: The Journal of Clinical Endocrinology & Metabolism
  • Language: English
  • DOI: 10.1210/clinem/dgaa348
  • ISSN: 0021-972X; 1945-7197
  • Keywords: Biochemistry (medical) ; Clinical Biochemistry ; Endocrinology ; Biochemistry ; Endocrinology, Diabetes and Metabolism
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objective</jats:title> <jats:p>We set forth to compare ethnicities for metabolic and immunological characteristics at the clinical diagnosis of type 1 diabetes (T1D) and assess the effect of ethnicity on beta-cell functional loss within 3 years after clinical diagnosis.</jats:p> </jats:sec> <jats:sec> <jats:title>Research Methods and Design</jats:title> <jats:p>We studied participants in TrialNet New Onset Intervention Trials (n = 624, median age = 14.4 years, 58% male, 8.7% Hispanic) and followed them prospectively for 3 years. Mixed meal tolerance tests (MMTT) were performed within 6 months following clinical diagnosis and repeated semiannually. Unless otherwise indicated, analyses were adjusted for age, sex, BMI Z-score, and diabetes duration.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>At T1D clinical diagnosis, Hispanics, compared with non-Hispanic whites (NHW), had a higher frequency of diabetic ketoacidosis (DKA) (44.7% vs 25.3%, OR = 2.36, P = 0.01), lower fasting glucose (97 vs 109 mg/dL, P = 0.02) and higher fasting C-peptide (1.23 vs 0.94 ng/mL, P = 0.02) on the first MMTT, and higher frequency of ZnT8 autoantibody positivity (n = 201, 94.1% vs 64%, OR = 7.98, P = 0.05). After exclusion of participants in experimental arms of positive clinical trials, C-peptide area under the curve (AUC) trajectories during the first 3 years after clinical diagnosis were not significantly different between Hispanics and NHW after adjusting for age, sex, BMI-z score, and DKA (n = 413, P = 0.14).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Despite differences in the metabolic and immunological characteristics at clinical diagnosis of T1D between Hispanics and NHW, C-peptide trajectories did not differ significantly in the first 3 years following clinical diagnosis after adjustment for body mass index and other confounders. These findings may inform the design of observational studies and intervention trials in T1D.</jats:p> </jats:sec>
  • Access State: Open Access