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BETA IMPACTS OUTCOMES

FUNCTIONAL BETA CELLS CAN IMPACT CLINICAL OUTCOMES1-9

ROLE IN GLYCEMIC CONTROL

RESIDUAL BETA-CELL FUNCTION IS ASSOCIATED WITH LOWER HbA1c LEVELS1
Chart depicts HbA1c levels based on residual beta-cell function as measured by C-peptide.

Study overview and limitations: results from Danish Study Group for Childhood Diabetes (DanDiabKids) evaluating 342 pediatric patients aged 4.8-18.9 years with T1D for 3 to 6 years. Limitations were reported for this study. Thirty-nine percent of children eligible for the study according to the DanDiabKids registry did not participate. The HbA1c used for the study was analyzed locally.1

RESIDUAL BETA-CELL FUNCTION IS ASSOCIATED WITH LONGER TIME IN RANGE2
Chart depicts time in range based on residual beta cell function as measured by urinary C-peptide-to-creatinine ratio (UCPCR).2

Study overview and limitations: results of a cross-sectional cohort study examining the association between residual beta-cell function and glucose control (as metrics of continuous glucose monitoring) in patients with T1D (N=499). Limitations were reported for this study. First, because of the cross-sectional design, it is impossible to make claims of causality. Second, the UCPCR is not considered as gold standard for measuring beta-cell function. Therefore, this study may underestimate the contribution of beta-cell function to CGM-derived metrics and HbA1c. Finally, in the Netherlands, individuals with inadequate glycemic control generally have access to more devices. It is seen that participants with less beta-cell function more often use pumps, but did not obtain a better TIR, suggesting that the association between TIR and UCPCR may be further underestimated in this cohort of individuals with access to advanced tools of diabetes management.2

RESIDUAL BETA-CELL FUNCTION HAS BEEN ASSOCIATED WITH REDUCED INCIDENCES OF SEVERE HYPOGLYCEMIA EVENTS​3-8
Chart depicts incidence of severe hypoglycemia events with at least 6 years of follow-up based on residual beta cell function as measured by C-peptide levels.

Data from the DCCT/EDIC studies

IMPACT ON OUTCOMES

Reduced risk of retinopathy and nephropathy are associated with residual beta-cell function.5,8-10

risk reduction of retinopathy observed
in patients with higher C-peptide levels9

(OR 0.55 [95% CI 0.34-0.89], P=0.014)

risk reduction of nephropathy observed
in patients with higher C-peptide levels9

(OR 0.61 [95% CI 0.38-0.96], P=0.033)

Higher C-peptide levels, indicative of higher residual beta-cell function, were observed with lower risk of microvascular complications5,9,10

T1D=type 1 diabetes.

EXPLORING THE BENEFITS AND FEASIBILITY OF...

A range of investigational mechanisms are currently being studied including, but not limited to:

Autoantibodies and a no symbol over them

DOWNREGULATION AND DISRUPTION OF T1D AUTOIMMUNE MECHANISMS11

A pancreas

IMPROVING INSULIN SENSITIVITY13

A cluster of beta cells with a revolving arrow around them

REGENERATION AND REPLACEMENT OF FUNCTIONAL BETA CELLS11

References


  1. Sørensen JS, Johannesen J, Pociot F, et al. 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. 
  2. Fuhri Snethlage CM, McDonald TJ, Oram RD, et al. Residual β-cell function is associated with longer time in range in individuals with type 1 diabetes. Diabetes Care. 2024;47(7):1114-1121.  
  3. Gubitosi-Klug RA, Braffett BH, Hitt S, et al. Residual β cell function in long-term type 1 diabetes associates with reduced incidence of hypoglycemia. J Clin Invest. 2021;131(3):e143011.
  4. Jeyam A, Colhoun H, McGurnaghan S, et al. Clinical impact of residual C-peptide secretion in type 1 diabetes on glycemia and microvascular complications. Diabetes Care. 2021;44(2):390-398.
  5. Palmer JP, Fleming GA, Greenbaum CJ, et al. C-peptide is the appropriate outcome measure for type 1 diabetes clinical trials to preserve beta-cell function: report of an ADA workshop, 21-22 October 2001. Diabetes. 2004;53(1):250-264.  
  6. 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. 
  7. Steffes MW, Sibley S, Jackson M, Thomas W. β-cell function and the development of diabetes-related complications in the diabetes control and complications trial. Diabetes Care. 2003;26(3):832-836.
  8. Nathan DM. Realising the long-term promise of insulin therapy: the DCCT/EDIC study. Diabetologia. 2021;64(5):1049-1058. 
  9. Harsunen M, Haukka J, Harjutsalo V, et al. Residual insulin secretion in individuals with type 1 diabetes in Finland: longitudinal and cross-sectional analyses. Lancet Diabetes Endocrinol. 2023;11(7):465-473. 
  10. Leighton E, Sainsbury CAR, Jones GC. A practical review of C-peptide testing in diabetes. Diabetes Ther. 2017;8(3):475-487. 
  11. Pociot F. Capturing residual beta cell function in type 1 diabetes. Diabetologia. 2019;62(1):28-32. 
  12. Von Scholten BJ, Kreiner FF, Gough SCL, von Herrath M. Current and future therapies for type 1 diabetes. Diabetologia. 2021;64(5):1037-1048. 
  13. Nowak C, Lind M, Sumnik Z, et al. Intralymphatic GAD-Alum (Diamyd®) improves glycemic control in type 1 diabetes with HLA DR3-DQ2. J Clin Endocrinol Metab. 2022;107(9):2644-2651. 
  14. National Cancer Institute. Definition of allogeneic human stem cell-derived pancreatic islet cells VX-880. Accessed February 12, 2025. 
  15. Pathak V, Pathak NM, O'Neill CL, Guduric-Fuchs J, Medina RJ. Therapies for type 1 diabetes: current scenario and future perspectives. Clin Med Insights Endocrinol Diabetes. 2019;12:1179551419844521.