TY - JOUR
T1 - Residual C-peptide is associated with new and persistent impaired awareness of hypoglycaemia in type 1 diabetes
AU - Dutch type 1 Biomarker group
AU - Varkevisser, R. D.M.
AU - Sas, T.
AU - Aanstoot, H. J.
AU - Wolffenbuttel, B. H.R.
AU - van der Klauw, M. M.
N1 - Publisher Copyright:
© 2024
PY - 2024/12
Y1 - 2024/12
N2 - 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.
AB - 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.
KW - c-Peptide
KW - Impaired awareness of hypoglycaemia
KW - Type 1 Diabetes
UR - http://www.scopus.com/inward/record.url?scp=85207934238&partnerID=8YFLogxK
U2 - 10.1016/j.jdiacomp.2024.108893
DO - 10.1016/j.jdiacomp.2024.108893
M3 - Article
C2 - 39500130
AN - SCOPUS:85207934238
SN - 1056-8727
VL - 38
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
IS - 12
M1 - 108893
ER -