{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T04:55:41Z","timestamp":1771563341594,"version":"3.50.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T00:00:00Z","timestamp":1650326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>C-peptide is conventionally used in assessing pancreatic function in patients with diabetes mellitus. The clinical significance of this molecule during the course of type 1 diabetes mellitus (T1DM) has been recently revisited. This study aimed to investigate the natural course of C-peptide in T1DM patients over the period of 15 years and analyze the association between the residual C-peptide and diabetes complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included a total of 234 children and adolescents with T1DM. Patient data including sex, age at diagnosis, anthropometric measures, daily insulin dose, serum HbA1c, post-prandial serum C-peptide levels, lipid profiles, and diabetic complications at the time of diagnosis and 1, 3, 5, 10, and 15 years after diagnosis were retrospectively collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 234 patients, 101 were men and 133 were women, and the mean patient age at initial diagnosis was 8.3 years. Serum C-peptide decreased constantly since the initial diagnosis, and showed a significant decline at 3 years after diagnosis. At 15 years after diagnosis, only 26.2% of patients had detectable serum C-peptide levels. The subgroup with older patients and patients with higher BMI standard deviation score showed higher mean serum C-peptide, but the group-by-time results were not significant, respectively. Patients with higher serum C-peptide required lower doses of insulin and had fewer events of diabetic ketoacidosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Serum C-peptide decreased consistently since diagnosis of T1DM, showing a significant decline after 3 years. Patients with residual C-peptide required a lower dose of insulin and had a lower risk for diabetic ketoacidosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.869204","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T05:12:25Z","timestamp":1650345145000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Insulin Requirement and Complications Associated With Serum C-Peptide Decline in Patients With Type 1 Diabetes Mellitus During 15 Years After Diagnosis"],"prefix":"10.3389","volume":"13","author":[{"given":"Junghwan","family":"Suh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hae In","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myeongseob","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyungchul","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han Saem","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahreum","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho-Seong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Wook","family":"Chae","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.54.suppl_2.s32","article-title":"Natural History of Beta-Cell Function in Type 1 Diabetes","author":"Sherry","year":"2005","journal-title":"Diabetes"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.53.1.250","article-title":"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","volume":"53","author":"Palmer","year":"2004","journal-title":"Diabetes"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-2115","article-title":"Continuous Glucose Monitoring After Islet Transplantation in Type 1 Diabetes: An Excellent Graft Function (B-Score Greater Than 7) Is Required to Abrogate Hyperglycemia, Whereas a Minimal Function Is Necessary to Suppress Severe Hypoglycemia (B-Score Greater Than 3)","volume":"97","author":"Vantyghem","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.3.832","article-title":"Beta-Cell Function and the Development of Diabetes-Related Complications in the Diabetes Control and Complications Trial","volume":"26","author":"Steffes","year":"2003","journal-title":"Diabetes Care"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2337\/db11-1423","article-title":"The Clinical Potential of C-Peptide Replacement in Type 1 Diabetes","volume":"61","author":"Wahren","year":"2012","journal-title":"Diabetes"},{"key":"B6","doi-asserted-by":"publisher","first-page":"270","DOI":"10.3390\/biomedicines9030270","article-title":"C-Peptide as a Therapy for Type 1 Diabetes Mellitus","volume":"9","author":"Washburn","year":"2021","journal-title":"Biomedicines"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvu211","article-title":"C-Peptide Replacement Therapy as an Emerging Strategy for Preventing Diabetic Vasculopathy","volume":"104","author":"Bhatt","year":"2014","journal-title":"Cardiovasc Res"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1172\/jci127397","article-title":"Residual B Cell Function and Monogenic Variants in Long-Duration Type 1 Diabetes Patients","volume":"129","author":"Yu","year":"2019","journal-title":"J Clin Invest"},{"key":"B9","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1038\/s10038-019-0705-2","article-title":"The Associations Between Three Genome-Wide Risk Variants for Serum C-Peptide of T1d and Autoantibody-Positive T1d Risk, and Clinical Characteristics in Chinese Population","volume":"65","author":"Feng","year":"2020","journal-title":"J Hum Genet"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.15.8.1009","article-title":"Homogeneity in Pattern of Decline of Beta-Cell Function in Iddm. 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