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Diabetes Care. 2008 Jul;31(7):1403-4. doi: 10.2337/dc08-0575.

Too much glucagon, too little insulin: time course of pancreatic islet dysfunction in new-onset type 1 diabetes.

Author information

1
National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA. brownrebecca@mail.nih.gov

Abstract

OBJECTIVE:

To determine the time course of changes in glucagon and insulin secretion in children with recently diagnosed type 1 diabetes.

RESEARCH DESIGN AND METHODS:

Glucagon and C-peptide concentrations were determined in response to standard mixed meals in 23 patients with type 1 diabetes aged 9.4 +/- 4.6 years, beginning within 6 weeks of diagnosis, and every 3 months thereafter for 1 year.

RESULTS:

Glucagon secretion in response to a physiologic stimulus (mixed meal) increased by 37% over 12 months, while C-peptide secretion declined by 45%. Fasting glucagon concentrations remained within the normal (nondiabetic) reference range.

CONCLUSIONS:

Postprandial hyperglucagonemia worsens significantly during the first year after diagnosis of type 1 diabetes and may represent a distinct therapeutic target. Fasting glucagon values may underestimate the severity of hyperglucagonemia. The opposing directions of abnormal glucagon and C-peptide secretion over time support the link between dysregulated glucagon secretion and declining beta-cell function.

PMID:
18594062
PMCID:
PMC2453684
DOI:
10.2337/dc08-0575
[Indexed for MEDLINE]
Free PMC Article
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