scholarly journals Slowed Metabolic Decline after One Year of Oral Insulin Treatment among Individuals at High Risk for Type 1 Diabetes in the Diabetes Prevention Trial-Type 1 and TrialNet Oral Insulin Prevention Trials

2020 ◽  
Author(s):  
Ada Admin ◽  
Jay M. Sosenko ◽  
Jay S. Skyler ◽  
Kevan C. Herold ◽  
Desmond A. Schatz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Placebo Group ◽  
High Risk ◽  
Trial Type ◽  
Diabetes Prevention ◽  
Prevention Trial ◽  
Oral Insulin ◽  
C Peptide ◽  
Insulin Group

We assessed whether oral insulin slowed metabolic decline after 1 year of treatment in individuals at high risk for type 1 diabetes.<b> </b>Two oral insulin trials that were negative overall with type 1 diabetes as the primary endpoint were analyzed: the Diabetes Prevention Trial-Type 1 (DPT-1) and TrialNet oral insulin trials. Oral glucose tolerance tests at baseline and after 1 year of treatment were analyzed. Among those at high risk [Diabetes Prevention Trial Risk Score (DPTRS)≥6.75], the AUC C-peptide increased significantly from baseline to 1 year in each oral insulin group, whereas AUC glucose increased significantly in each placebo group. At 1 year, AUC C-peptide/AUC glucose was significantly higher (p<0.05) in the oral insulin group than in the placebo group in each trial (p=0.057 with age adjustment in the TrialNet trial; p<0.01 for trials combined with or without age adjustment). For DPTRS<6.75, oral insulin groups did not differ from placebo groups. <a>The findings suggest that 1 year of treatment with oral insulin slows metabolic deterioration in individuals at high risk for type 1 diabetes.</a> Moreover, the findings further suggest that metabolic endpoints can be useful adjuncts to the diagnostic endpoint in assessments of preventive treatments for the disorder.

scholarly journals Slowed Metabolic Decline after One Year of Oral Insulin Treatment among Individuals at High Risk for Type 1 Diabetes in the Diabetes Prevention Trial-Type 1 and TrialNet Oral Insulin Prevention Trials

2020 ◽  
Author(s):  
Ada Admin ◽  
Jay M. Sosenko ◽  
Jay S. Skyler ◽  
Kevan C. Herold ◽  
Desmond A. Schatz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Placebo Group ◽  
High Risk ◽  
Trial Type ◽  
Diabetes Prevention ◽  
Prevention Trial ◽  
Oral Insulin ◽  
C Peptide ◽  
Insulin Group

We assessed whether oral insulin slowed metabolic decline after 1 year of treatment in individuals at high risk for type 1 diabetes.<b> </b>Two oral insulin trials that were negative overall with type 1 diabetes as the primary endpoint were analyzed: the Diabetes Prevention Trial-Type 1 (DPT-1) and TrialNet oral insulin trials. Oral glucose tolerance tests at baseline and after 1 year of treatment were analyzed. Among those at high risk [Diabetes Prevention Trial Risk Score (DPTRS)≥6.75], the AUC C-peptide increased significantly from baseline to 1 year in each oral insulin group, whereas AUC glucose increased significantly in each placebo group. At 1 year, AUC C-peptide/AUC glucose was significantly higher (p<0.05) in the oral insulin group than in the placebo group in each trial (p=0.057 with age adjustment in the TrialNet trial; p<0.01 for trials combined with or without age adjustment). For DPTRS<6.75, oral insulin groups did not differ from placebo groups. <a>The findings suggest that 1 year of treatment with oral insulin slows metabolic deterioration in individuals at high risk for type 1 diabetes.</a> Moreover, the findings further suggest that metabolic endpoints can be useful adjuncts to the diagnostic endpoint in assessments of preventive treatments for the disorder.

scholarly journals Slowed Metabolic Decline After 1 Year of Oral Insulin Treatment Among Individuals at High Risk for Type 1 Diabetes in the Diabetes Prevention Trial–Type 1 (DPT-1) and TrialNet Oral Insulin Prevention Trials

Diabetes ◽  
2020 ◽  
Vol 69 (8) ◽  
pp. 1827-1832 ◽  
Author(s):  
Jay M. Sosenko ◽  
Jay S. Skyler ◽  
Kevan C. Herold ◽  
Desmond A. Schatz ◽  
Michael J. Haller ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
High Risk ◽  
Trial Type ◽  
Diabetes Prevention ◽  
Insulin Treatment ◽  
Prevention Trial ◽  
Oral Insulin ◽  
Prevention Trials

scholarly journals Glucose and C-Peptide Changes in the Perionset Period of Type 1 Diabetes in the Diabetes Prevention Trial-Type 1

Diabetes Care ◽  
2008 ◽  
Vol 31 (11) ◽  
pp. 2188-2192 ◽  
Author(s):  
J. M. Sosenko ◽  
J. P. Palmer ◽  
L. Rafkin-Mervis ◽  
J. P. Krischer ◽  
D. Cuthbertson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Trial Type ◽  
Diabetes Prevention ◽  
Prevention Trial ◽  
C Peptide

1344-P: Persistent ß-Cell Responsiveness in Children at High Risk for Type 1 Diabetes (T1D) Is Associated with Decreased Progression to T1D in the Diabetes Prevention Trial-Type 1 (DPT-1)

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1344-P
Author(s):  
EMILY K. SIMS ◽  
HEBA M. ISMAIL ◽  
BRANDON M. NATHAN ◽  
JAY M. SOSENKO
Keyword(s):  
Type 1 Diabetes ◽  
High Risk ◽  
Trial Type ◽  
Diabetes Prevention ◽  
Prevention Trial

scholarly journals The influence of body mass index and age on C-peptide at the diagnosis of type 1 diabetes in children who participated in the diabetes prevention trial-type 1

2017 ◽  
Vol 19 (3) ◽  
pp. 403-409 ◽  
Author(s):  
Jay M Sosenko ◽  
Susan Geyer ◽  
Jay S Skyler ◽  
Lisa E Rafkin ◽  
Heba M Ismail ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Type 1 Diabetes ◽  
Body Mass ◽  
Trial Type ◽  
Diabetes Prevention ◽  
Prevention Trial ◽  
C Peptide

scholarly journals Trends of Earlier and Later Responses of C-peptide to Oral Glucose Challenges With Progression to Type 1 Diabetes in Diabetes Prevention Trial-Type 1 Participants

Diabetes Care ◽  
2009 ◽  
Vol 33 (3) ◽  
pp. 620-625 ◽  
Author(s):  
J. M. Sosenko ◽  
J. P. Palmer ◽  
L. E. Rafkin ◽  
J. P. Krischer ◽  
D. Cuthbertson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Trial Type ◽  
Diabetes Prevention ◽  
Prevention Trial ◽  
Oral Glucose ◽  
C Peptide

scholarly journals One-Hour Oral Glucose Tolerance Tests for the Prediction and Diagnostic Surveillance of Type 1 Diabetes

2020 ◽  
Vol 105 (11) ◽  
Author(s):  
Kimber M Simmons ◽  
Jay M Sosenko ◽  
Megan Warnock ◽  
Susan Geyer ◽  
Heba M Ismail ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Tolerance ◽  
Risk Score ◽  
Trial Type ◽  
Diabetes Prevention ◽  
Prevention Trial ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
C Peptide

Abstract Context Once islet autoantibody–positive individuals are identified, predicting which individuals are at highest risk for type 1 diabetes (T1D) is important. A metabolic risk score derived from 2-hour oral glucose tolerance test (OGTT) data, the Diabetes Prevention Trial-Type 1 risk score (DPTRS), can accurately predict T1D. However, 2-hour OGTTs are time-consuming and costly. Objective We aimed to determine whether a risk score derived from 1-hour OGTT data can predict T1D as accurately as the DPTRS. Secondarily, we evaluated whether a 1-hour glucose value can be used for diagnostic surveillance. Methods The DPTRS was modified to derive a 1-hour OGTT risk score (DPTRS60) using fasting C-peptide, 1-hour glucose and C-peptide, age, and body mass index. Areas under receiver operating curves (ROCAUCs) were used to compare prediction accuracies of DPTRS60 with DPTRS in Diabetes Prevention Trial–Type 1 (DPT-1) (n = 654) and TrialNet Pathway to Prevention (TNPTP) (n = 4610) participants. Negative predictive values (NPV) for T1D diagnosis were derived for 1-hour glucose thresholds. Results ROCAUCs for T1D prediction 5 years from baseline were similar between DPTRS60 and DPTRS (DPT-1: 0.805 and 0.794; TNPTP: 0.832 and 0.847, respectively). DPTRS60 predicted T1D significantly better than 2-hour glucose (P &lt; .001 in both cohorts). A 1-hour glucose of less than 180 mg/dL had a similar NPV, positive predictive value, and specificity for T1D development before the next 6-month visit as the standard 2-hour threshold of less than 140 mg/dL (both ≥ 98.5%). Conclusion A 1-hour OGTT can predict T1D as accurately as a 2-hour OGTT with minimal risk of missing a T1D diagnosis before the next visit.

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