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Insulin production found in some people with long-term type 1 diabetes

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American Diabetes Association 68th Scientific Sessions

A significant proportion of people who have had type 1 diabetes for over 50 years may still have the capacity to produce insulin, according to results of a study presented today at the American Diabetes Association 68th Scientific Sessions.

George King, MD, director of research at the Joslin Diabetes Center in Boston, and colleagues examined the presence of IA2, GADA, c-peptide levels, advanced glycation end products, and complications and anthropometrics of participants enrolled in the Medalist Study. They followed participants who were living with diabetes for 50 years or more to better understand the factors that contribute to their longevity.

Findings showed that 17% of more than 300 participants still produced insulin.

“This was a big surprise to everyone,” King said in a press release. “If people who have had type 1 diabetes for this long have residual insulin production, then those who have had the disease for less time might have an even greater capacity to produce insulin.”

Specifically, the researchers found that for c-peptide, 63.9% of participants had levels greater than 0.1 ng/mL, 17.2% had levels greater than 0.3 ng/mL, and 3.6% had levels greater than 0.5 ng/mL, according to the study. Over 20% of those with c-peptide levels greater than 0.3 ng/mL were antibody positive (P=.08).

Further, 31% had either GAD or IA2 antibodies despite years of exogenous insulin use, according to the study. King and colleagues found no differences in levels of HbA1c, advanced glycation end products and complications between those with and without c-peptide or antibodies.

“Even people with diabetes for 50 to 80 years potentially still have some islet cells in the pancreas that have survived and could still make insulin,” he said. “If we can find a way to revive these cells in patients, particularly those with fewer years with diabetes, it could mean new ways to treat the disease.” – by Tara Grassia

For more information:

• Keenan HA, Sun J, Paul L, et al. OR-173. Do antibodies signal residual insulin production in patients with 50 or more years of type 1 diabetes? Presented at: American Diabetes Association 68th Scientific Sessions; June 6-10, 2008; San Francisco