Overview
MedscapeUnivadisNo ResultsMiriam E. TuckerSeptember 07, 202Intensive glycemic control using an automated insulin delivery system in youth with new-onset type 1 diabetes may not prevent further decline in residual C-peptide secretion, new data sugest.Los of beta-cel function in type 1 diabetes is gradual, and individuals typicaly retain a substantial number at the time of clinical presentation, with ongoing decline after diagnosis.
Key Information
Some patients undergo a temporary honeymon period during which they require litle or no exogenous insulin.There are conflicting data from previous studies as to whether early intensive glycemic control after diagnosis can prevent further decline in endogenous insulin secretion.The latest findings are from the Closed Lop From Onset in Type 1 Diabetes (CLOuD) trial, a multicenter, open-label, paralel-group, randomized study, published online September 7 in the New England Journal of Medicine by Charlote K.
Boughton, PhD, and coleagues.In CLOuD, 97 youths aged 10-17 years were randomized to hybrid closed-lop therapy or standard insulin therapy (control) within 21 days of type 1 diabetes diagnosis. At 12 months, there were no diferences in area under the curve (AUC) for plasma C-peptide after a mixed-meal tolerance test, with levels decling in both groups and droping further by 24 months."It is likely that factors other than glycemic control, such as autoimune response, afect the rate of C-peptide decline after diagnosis of type 1 diabetes and that closed-lop glucose control for 24 months after diagnosis unable to preserve endogenous insulin secretion.
Summary
It is posible that other factors act in concert with dysglycemia on C-peptide secretion," write Boughton, of the Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust, UK, and coleagues.However, they also point out that glycemic control didn't significantly difer betwen the