Residual C-peptide is associated with new and persistent impaired awareness of hypoglycaemia in type 1 diabetes

Dutch type 1 Biomarker group, R. D.M. Varkevisser*, T. Sas, H. J. Aanstoot, B. H.R. Wolffenbuttel, M. M. van der Klauw

*Corresponding author voor dit werk

OnderzoeksoutputAcademicpeer review

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Aims: To describe the change in impaired awareness of hypoglycaemia (IAH) over time and to identify factors associated with this change in the Dutch Type 1 Diabetes biomarkers cohort (NCT04977635).

Methods: A prospective cohort of type 1 diabetes patients, with C-peptide <300 pmol/L, who had completed the Clarke questionnaire, to determine IAH status, at baseline and after 2 years. Changes in awareness status were defined and compares as follows: unchanged normal awareness (NAH) versus unchanged IAH, new IAH versus reversal of IAH. Multivariate logistic regression models were fitted using forward and backward stepwise selection using a 0.10 P-value cut-off, and stepwise backward selection using AIC criteria.

Results: A total of 431 out of 611 participants were included. The baseline prevalence of IAH was 17 % and 20 % after 2 years. The incidence proportion of new IAH and reversal of IAH were, 9.5 % and 31 %, respectively. For every 2.7-fold increase in C-peptide, the odds of IAH decrease by 58 %. A 1-unit increase in BMI over the 2-year follow-up period is associated with a 5.27-fold increase in the odds of reversing IAH.

Conclusions: Higher C-peptide levels are protective against new IAH, and an increase in BMI over time is associated with the reversal of IAH.

Originele taal-2English
Artikelnummer108893
Aantal pagina's6
TijdschriftJournal of Diabetes and its Complications
Volume38
Nummer van het tijdschrift12
DOI's
StatusPublished - dec.-2024

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