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Quantifying beta cell function in the preclinical stages of type 1 diabetes

Galderisi, Alfonso, Carr, Alice L. J., Martino, Mariangela, Taylor, Peter ORCID:, Senior, Peter and Dayan, Colin ORCID: 2023. Quantifying beta cell function in the preclinical stages of type 1 diabetes. Diabetologia 66 , pp. 2189-2199. 10.1007/s00125-023-06011-5

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Clinically symptomatic type 1 diabetes (stage 3 type 1 diabetes) is preceded by a pre-symptomatic phase, characterised by progressive loss of functional beta cell mass after the onset of islet autoimmunity, with (stage 2) or without (stage 1) measurable changes in glucose profile during an OGTT. Identifying metabolic tests that can longitudinally track changes in beta cell function is of pivotal importance to track disease progression and measure the effect of disease-modifying interventions. In this review we describe the metabolic changes that occur in the early pre-symptomatic stages of type 1 diabetes with respect to both insulin secretion and insulin sensitivity, as well as the measurable outcomes that can be derived from the available tests. We also discuss the use of metabolic modelling to identify insulin secretion and sensitivity, and the measurable changes during dynamic tests such as the OGTT. Finally, we review the role of risk indices and minimally invasive measures such as those derived from the use of continuous glucose monitoring.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Springer
ISSN: 0012-186X
Date of First Compliant Deposit: 5 October 2023
Date of Acceptance: 8 August 2023
Last Modified: 20 Nov 2023 14:41

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