Lower residual beta-cell function among diabetic children with familiar disposition

Anna Jessen Rubaek, Esben Thyssen Vestergaard, Kurt Kristensen and Jesper Sand Sorensen

Objective: Type 1 Diabetes (T1DM) is an autoimmune, multifactorial disease that causes dysregulation of blood glucose and may result in severe complications. The disease still causes long-term complications whereby the treatment is not at its optimum. This study investigates the impact of Family History of T1DM (FHD) on children and adolescents with T1DM by analyzing differences in Diabetic Ketoacidosis (DKA); HbA1c at onset; and HbA1c and residual insulin secretion 3-6 years after the onset of T1DM. Method: 342 children with a diabetes duration of 3-6 years and onset before the age of 15 years analysis. Results: The key finding is, that children with FHD have lower stimulated c-peptide after 3-6 years after onset compared to the controls without FHD (p=0.048). Subjects with FHD have significantly lower levels of HbA1c at the onset of T1DM (p=0.005) and less frequent DKA at onset (p=0.004). No difference in HbA1c 3-6 years after onset was found. Conclusion: The lower stimulated c-peptide in subjects with FHD suggests that they have a lower beta-cell function and that they have a more aggressive form of diabetes than children without FHD. Less DKA and lower HbA1c at onset are a result of earlier diagnosis. The study is the largest of its kind but still, it was limited by a small study population whereby further studies are needed to investigate the impact of first-degree relatives with T1DM on metabolic control.