Amendolara Rocco, Zampetti Simona, Siena Antonio, D'Onofrio Luca, De Vita Francesco, Barbaro Federica, Notarnicola Dario, Sessa Rosario Luigi, Luverà Daniela, Risi Renata, Maddaloni Ernesto, Buzzetti Raffaella
Department of Experimental Medicine, Sapienza University of Rome, Italy; Department of Molecular Medicine, Sapienza University of Rome, Italy.
Department of Experimental Medicine, Sapienza University of Rome, Italy.
Diabetes Res Clin Pract. 2025 Mar;221:112006. doi: 10.1016/j.diabres.2025.112006. Epub 2025 Jan 23.
To investigate whether the risk of hypoglycemia is associated with residual β-cell function in adults with type 1 diabetes (T1D).
This cross-sectional study included 61 subjects with T1D duration <15 years using continuous glucose monitoring (CGM). Random C-peptide levels were compared between participants with time below range (TBR) ≥3 % (n = 15) and TBR <3 % (n = 45). The associations of C-peptide levels with other CGM metrics and clinical characteristics of the study participants were also tested. Analyses were adjusted for disease duration.
Median [25 - 75 percentiles] C-peptide levels were generally low: 49.3 [15.7-152] pmol/L. Participants in the low-TBR group had significantly higher C-peptide levels compared to those in the high-TBR group (52.9 [19.5-176.3] vs. 21.0 [9.4-106.6] pmol/L, p = 0.036), independently from disease duration. Higher C-peptide levels were associated with better CGM-metrics (p < 0.05). A C-peptide threshold of 15.1 pmol/L was the best cut-off to distinguish people at high risk of hypoglycemia.
C-peptide microsecretion is associated with a low risk of hypoglycemia and improved CGM metrics. Therapeutic approaches aimed at preserving minimal C-peptide secretion could potentially enhance glycemic outcomes and reduce hypoglycemic risk in individual with T1D.
探讨1型糖尿病（T1D）成人患者低血糖风险是否与残余β细胞功能相关。
这项横断面研究纳入了61例T1D病程<15年且使用持续葡萄糖监测（CGM）的受试者。比较血糖低于目标范围（TBR）≥3%的参与者（n = 15）和TBR<3%的参与者（n = 45）的随机C肽水平。还测试了C肽水平与其他CGM指标及研究参与者临床特征之间的关联。分析对病程进行了校正。
C肽水平中位数[25 - 75百分位数]普遍较低：49.3[15.7 - 152]pmol/L。低TBR组参与者的C肽水平显著高于高TBR组（52.9[19.5 - 176.3] vs. 21.0[9.4 - 106.6]pmol/L，p = 0.036），不受病程影响。较高的C肽水平与更好的CGM指标相关（p<0.05）。C肽阈值为15.1 pmol/L是区分低血糖高危人群的最佳切点。
C肽微量分泌与低血糖风险低及CGM指标改善相关。旨在保留最低限度C肽分泌的治疗方法可能会改善T1D患者的血糖结局并降低低血糖风险。
