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The Betaverse was a place of productivity and glucose homeostasis.1 But that changed when an unknown environmental force triggered T1D.1,2 Damaged beta cells released antigens...T1D autoantibodies appeared…And the T cells came!3 Acting unusually…Hypervigilant. Autoreactive. DESTROYING. But destroying the very Betas they usually protect.3 With T cells on the scene, things can get ugly!4,5 Yes, insulin production is impaired, but Betas do so much more.6-8 Must regulate A1C.8 Must protect against retinopathy and nephropathy.3,8  Reduce hypoglycemic risk.3,8 But, activated T cells continue to destroy!3 Stay with us old friend! Some of us are better than none of us!8 To determine if Betas are under an immune attack, screen for islet autoantibodies.5 A better understanding of T1D and beta-cell dysfunction may help inform the development of novel treatment approaches.9

BETA-CELL FUNCTION:

DETERMINES PATIENTS’ T1D JOURNEYS

Beta-cell function goes beyond making insulin and can affect an underlying autoimmune process of T1D.5

DRIVES T1D PATHOPHYSIOLOGY

Beta-cell destruction is driven by an autoimmune attack and could be a key factor in indicating how far a patient has progressed.5,15,16

DEFINES OUTCOMES IN T1D

Some functional beta cells are better than none. In T1D, even low beta-cell function can produce some endogenous insulin.8,12,17-21

*The C-peptide threshold for clinically meaningful beta-cell function is 0.2 pmol/mL or ≥0.6 ng/mL.10,11†
†Based on a conversion from 0.2 pmol/mL using the molecular weight of 3020.3 g/mol for C-peptide.4,11-13

T1D=type 1 diabetes.

References

  1. Podobnik B, Korošak D, Skelin Klemen M, et al. β cells operate collectively to help maintain glucose homeostasis. Biophys J. 2020;118(10):2588-2595.  

  2. Op de Beeck A, Eizirik DL. Viral infections in type 1 diabetes mellitus—why the β cells? Nat Rev Endocrinol. 2016;12(5):263-273.

  3. Katsarou A, Gudbjörnsdottir S, Rawshani A, et al. Type 1 diabetes mellitus. Nat Rev Dis Primers. 2017;3:17016. 

  4. Latres E, Greenbaum CJ, Oyaski ML, et al. Evidence for C-peptide as a validated surrogate to predict clinical benefits in trials of disease-modifying therapies for type 1 diabetes. Diabetes. 2024;73(6):823-833.

  5. Scheiner G, Weiner S, Kruger D, Pettus J. Screening for type 1 diabetes: role of the diabetes care and education specialist. ADCES Pract. 2022;10(5):20-25. 

  6. Röder PV, Wu B, Liu Y, Han W. Pancreatic regulation of glucose homeostasis. Exp Mol Med. 2016;48(3):e219. 

  7. American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: standards of care in diabetes—2025. Diabetes Care. 2025;48(suppl 1):S27-S49. 

  8. Sørensen JS, Johannesen J, Pociot F, et al; Danish Society for Diabetes in Childhood and Adolescence. Residual β-cell function 3-6 years after onset of type 1 diabetes reduces risk of severe hypoglycemia in children and adolescents. Diabetes Care. 2013;36(11):3454-3459. 

  9. Ramos EL, Dayan CM, Chatenoud L, et al; PROTECT Study Investigators. Teplizumab and β-cell function in newly diagnosed type 1 diabetes. N Engl J Med. 2023;389(23):2151-2161.

  10. Jones AG, Hattersley AT. The clinical utility of C-peptide measurement in the care of patients with diabetes. Diabet Med. 2013;30(7):803-817.

  11. Leighton E, Sainsbury CAR, Jones GC. A practical review of C-peptide testing in diabetes. Diabetes Ther. 2017;8(3):475-487. 

  12. Palmer JP, Fleming GA, Greenbaum CJ, et al. C-peptide is the appropriate outcome measure for type 1 diabetes clinical trials to preserve β-cell function: report of an ADA workshop, 21-22 October 2001. Diabetes. 2004;53(1):250-264.

  13. Pociot F. Capturing residual beta cell function in type 1 diabetes. Diabetologia. 2019;62(1):28-32.

  14. Scheiner G, Weiner S, Kruger DF, et al. Screening for type 1 diabetes: role of the diabetes care and education specialist. ADCES Pract. 2022;10(5):20-25. 

  15. Röder PV, Wu B, Liu Y, et al. Pancreatic regulation of glucose homeostasis. Exp Mol Med. 2016;48(3):e219.

  16. Insel RA, Dunne JL, Atkinson MA, et al. Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care. 2015;38(10):1964-1974.

  17. Jeyam A, Colhoun H, McGurnaghan S, et al; SDRNT1BIO Investigators. Clinical impact of residual C-peptide secretion in type 1 diabetes on glycemia and microvascular complications. Diabetes Care. 2021;44(2):390-398. 

  18. Gubitosi-Klug RA, Braffett BH, Hitt S, et al; DCCT/EDIC Research Group. Residual β cell function in long-term type 1 diabetes associates with reduced incidence of hypoglycemia. J Clin Invest. 2021;131(3):e143011. 

  19. Lachin JM, McGee P, Palmer JP; DCCT/EDIC Research Group. Impact of C-peptide preservation on metabolic and clinical outcomes in the Diabetes Control and Complications Trial. Diabetes. 2014;63(2):739-748. 

  20. Steffes MW, Sibley S, Jackson M, et al. β-cell function and the development of diabetes-related complications in the diabetes control and complications trial. Diabetes Care. 2003;26(3):832-836. 

  21. Nathan DM. Realising the long-term promise of insulin therapy: the DCCT/EDIC study. Diabetologia. 2021;64(5):1049-1058.

MAT-US-2500681-v3.0-03/2026