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Åke Lernmark

Principal investigator

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Decline of C-peptide during the first year after diagnosis of Type 1 diabetes in children and adolescents


  • Johnny Ludvigsson
  • Annelie Carlsson
  • Ahmed Deli
  • Gun Forsander
  • Sten Ivarsson
  • Ingrid Kockum
  • Bengt Lindblad
  • Claude Marcus
  • Ake Lernmark
  • Ulf Samuelsson

Summary, in English

Aims/hypothesis: We studied the decline of C-peptide during the first year after diagnosis of Type 1 diabetes (T1D), and its relation to various factors. Methods: 3824/4017 newly diagnosed patients (95%) were classified as T1D in a national study. In a non-selected subgroup of 1669 T1D patients we determined non-fasting C-peptide both at diagnosis and after 1 year, and analyzed decline in relation to clinical symptoms and signs, initial C-peptide and occurrence of auto-antibodies. Results: Younger children lost more C-peptide (p < 0.001) and the higher the C-peptide at diagnosis the larger the decline during the first year (p < 0.0000). Patients with higher BMI had higher C-peptide at diagnosis but lost more (p < 0.01), and those with lower HbA1c, without symptoms and signs at diagnosis, and with higher BMI, had higher C-peptide at diagnosis, but lost more during the first year (p < 0.001). Finally, patients diagnosed during autumn had higher C-peptide at diagnosis, but lost more during the coming year (p < 0.001). Occurrence of auto-antibodies did not correlate with C-peptide decline, except possibly for a more rapid loss in IAA-positive patients. Conclusions/interpretation: Even in a restricted geographical area and narrow age range (< 18 years), the natural course of Type 1 diabetes is heterogeneous. This should be considered in clinical trials. (C) 2013 Elsevier Ireland Ltd. All rights reserved.


  • Paediatrics (Lund)
  • Paediatric Endocrinology
  • Vascular Diseases - Clinical Research
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • Diabetes and Celiac Unit

Publishing year







Diabetes Research and Clinical Practice





Document type

Journal article




  • Endocrinology and Diabetes


  • C-peptide
  • Natural course
  • Type 1 diabetes
  • Children
  • BMI
  • Intervention
  • trials



Research group

  • Paediatric Endocrinology
  • Vascular Diseases - Clinical Research
  • Diabetes and Celiac Unit


  • ISSN: 1872-8227