A CROSS-SECTIONAL STUDY TO ASSESS BETA CELL FUNCTION IN YOUNG ONSET TYPE 2 DIABETES MELLITUS (T2DM)

Authors

  • S Nagaratnam Hospital Putrajaya, Malaysia
  • SH Foo Department of Medicine, Hospital Selayang, Malaysia
  • S Rajoo Department of Medicine, Hospital Kuala Lumpur, Malaysia
  • MB Long Bidin Department of Medicine, Hospital Kuala Lumpur, Malaysia
  • NS Che Rahim Hospital Kuala Lumpur, Malaysia
  • S Tharmathurai Hospital Kuala Lumpur, Malaysia
  • M Arip Institute for Medical Research, Malaysia
  • YM Ching Institute for Medical Research, Malaysia

DOI:

https://doi.org/10.15605/jafes.036.S20

Keywords:

diabetes, young

Abstract

INTRODUCTION
Young-onset type 2 diabetes (T2D) is a heterogenous subset with variable clinical characteristics, disease progression, risk of complications and therapeutic response. This study aimed to examine beta cell function of these patients early in the disease using basal and stimulated C-peptide. We also looked at the association between metabolic parameters and diabetes complications with C-peptide levels.

METHODOLOGY
A dual center cross-sectional study was conducted in 113 young-onset T2D between 18 to 35 years of age, with a maximum disease duration of 5 years and negative diabetes autoantibodies. Plasma basal and stimulated C-peptide was measured before and 6 minutes after intravenous injection of 1 mg glucagon.

RESULTS
The median (interquartile range) of basal and stimulated C-peptide was 619.0 (655.0) pmol/L and 1231.0 (1024) pmol/L, respectively. Majority of our patients had adequate basal and stimulated beta cell function (85.8% basal and 77.9% stimulated). More than half of these patients were on insulin therapy. When the insulin-treated subgroup was analysed, 77.0% had adequate basal and 69.7% had adequate stimulated beta cell function. Multivariable linear regression analysis showed hypertension and obesity as independent predictors of high basal and stimulated C-peptide levels. There was also a significant independent association between the presence of nephropathy and higher basal C-peptide levels, but not stimulated C- peptide.

CONCLUSION
We have shown that most young-onset T2DM have adequate beta cell function during their early course of disease despite insulin therapy. A markedly elevated C-peptide level in those with a metabolic syndrome phenotype and nephropathy may suggest insulin resistance as the key driving factor during early disease. Further studies measuring insulin resistance in this population may help confirm this finding.

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Author Biographies

S Nagaratnam, Hospital Putrajaya, Malaysia


Endocrine Unit, Department of Medicine

SH Foo, Department of Medicine, Hospital Selayang, Malaysia

Endocrine Unit

S Rajoo, Department of Medicine, Hospital Kuala Lumpur, Malaysia

Endocrine Unit

MB Long Bidin, Department of Medicine, Hospital Kuala Lumpur, Malaysia

Endocrine Unit

NS Che Rahim, Hospital Kuala Lumpur, Malaysia

Department of Pathology

S Tharmathurai, Hospital Kuala Lumpur, Malaysia

Department of Ophthalmology

M Arip, Institute for Medical Research, Malaysia


Allergy and Immunology Research Centre

YM Ching, Institute for Medical Research, Malaysia


Allergy and Immunology Research Centre

References

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Published

2021-07-28

How to Cite

Nagaratnam, S. ., Foo, S. ., Rajoo, S., Bidin, M. L., Rahim, N. C. ., Tharmathurai, S. ., Arip, M., & Ching, Y. (2021). A CROSS-SECTIONAL STUDY TO ASSESS BETA CELL FUNCTION IN YOUNG ONSET TYPE 2 DIABETES MELLITUS (T2DM). Journal of the ASEAN Federation of Endocrine Societies, 36, 20. https://doi.org/10.15605/jafes.036.S20

Issue

Section

Abstracts for Oral Presentation | Adult