Abstract
Background: Emerging therapies aim to preserve insulin secretion (measured using cpeptide) in type 1 diabetes. The impact of preserved insulin secretion in adult-onset diabetes, and on non glycemic outcomes, is unclear.
Aims: To determine the impacts of retained endogenous insulin secretion on glycemic control, healthcare utilisation and patient quality of life (QOL) in adult on-set type 1 diabetes.
Methods: StartRight Study is a prospective study.
Results: Participants with retained insulin secretion (c-peptide ≥ 200 pmol/L), in
comparison to those with c-peptide <200pmol/L had significantly:
- Better glycaemic control: mean HbA1c 6.5 mmol/mol lower than those with severe insulin deficiency (c-peptide < 200 pmol/L) (58.0 vs 64.5 mmol/mol, p< 0.001)
- Fewer hospital admissions over the prior year for any cause in comparison to the severe insulin deficient group: (4% vs 13%, p< 0.01)
Where ≥1 admission:
- Less nights in hospital (mean 2.2 vs 4.9 nights, p= 0.001) and less likely to report ketoacidosis (0% vs 32.4% of admissions, p= 0.001) compared to participants with severe insulin deficiency.
Conclusion: - Participants with severe insulin deficiency (c-peptide < 200pmol/L) attended fewer outpatient healthcare appointments (including general practitioners, diabetes specialist doctors, diabetes specialist nurses, community diabetes nurses, community diabetes clinics) over the previous 12 months (3.5 vs 4.3
appointments, p> 0.05).
- QOL did not differ by c-peptide status (mean SF-12 102 vs 101, p= 0.5).
Conclusions: - In adult-onset type 1 diabetes, retained c-peptide level >200pmol/L four years
post-diagnosis is associated with significantly better glycemic control, fewer hospital admissions, reduced total nights in hospital, fewer episodes of diabetic ketoacidosis and reduction in outpatient contact with healthcare professionals. - This supports the commissioning of therapies to preserve beta cell function
to shift adult-onset type 1 diabetes management and reduce strain on healthcare resources.
Aims: To determine the impacts of retained endogenous insulin secretion on glycemic control, healthcare utilisation and patient quality of life (QOL) in adult on-set type 1 diabetes.
Methods: StartRight Study is a prospective study.
Results: Participants with retained insulin secretion (c-peptide ≥ 200 pmol/L), in
comparison to those with c-peptide <200pmol/L had significantly:
- Better glycaemic control: mean HbA1c 6.5 mmol/mol lower than those with severe insulin deficiency (c-peptide < 200 pmol/L) (58.0 vs 64.5 mmol/mol, p< 0.001)
- Fewer hospital admissions over the prior year for any cause in comparison to the severe insulin deficient group: (4% vs 13%, p< 0.01)
Where ≥1 admission:
- Less nights in hospital (mean 2.2 vs 4.9 nights, p= 0.001) and less likely to report ketoacidosis (0% vs 32.4% of admissions, p= 0.001) compared to participants with severe insulin deficiency.
Conclusion: - Participants with severe insulin deficiency (c-peptide < 200pmol/L) attended fewer outpatient healthcare appointments (including general practitioners, diabetes specialist doctors, diabetes specialist nurses, community diabetes nurses, community diabetes clinics) over the previous 12 months (3.5 vs 4.3
appointments, p> 0.05).
- QOL did not differ by c-peptide status (mean SF-12 102 vs 101, p= 0.5).
Conclusions: - In adult-onset type 1 diabetes, retained c-peptide level >200pmol/L four years
post-diagnosis is associated with significantly better glycemic control, fewer hospital admissions, reduced total nights in hospital, fewer episodes of diabetic ketoacidosis and reduction in outpatient contact with healthcare professionals. - This supports the commissioning of therapies to preserve beta cell function
to shift adult-onset type 1 diabetes management and reduce strain on healthcare resources.
| Original language | English |
|---|---|
| Publication status | Published - 26 Feb 2025 |
| Event | Diabetes UK Annual Professional Conference 2025 - SEC, Glasgow, United Kingdom Duration: 26 Feb 2025 → 28 Feb 2025 https://www.diabetes.org.uk/diabetes-uk-professional-conference |
Conference
| Conference | Diabetes UK Annual Professional Conference 2025 |
|---|---|
| Abbreviated title | DUK APC |
| Country/Territory | United Kingdom |
| City | Glasgow |
| Period | 26/02/25 → 28/02/25 |
| Internet address |