AIMS/HYPOTHESIS We aimed to assess whether persistence of C-peptide secretion is associated with less glucose variability and fewer low-glucose events in adults with type 1 diabetes who use flash monitoring. METHODS We performed a cross-sectional study of 290 adults attending a university teaching hospital diabetes clinic, with type 1 diabetes, who use flash monitoring and in whom a random plasma C-peptide was available in the past 2 years. Variables relating to flash monitoring were compared between individuals with low C-peptide (<10 pmol/l) and those with persistent C-peptide (either 10-200 pmol/l or 10-50 pmol/l). In addition, the relationship between self-reported hypoglycaemia and C-peptide was assessed (n = 167). Data are median (interquartile range). RESULTS Individuals with preserved C-peptide secretion (10-200 pmol/l) had shorter duration of diabetes (15 [9-24] vs 25 [15-34] years, p < 0.001) and older age at diagnosis (23 [14-28] vs 15 [9-25] years, p < 0.001), although current age did not differ in this cohort. Preserved C-peptide was associated with lower time with glucose <3.9 mmol/l (3% [2-6%] vs 5% [3-9%], p < 0.001), fewer low-glucose events per 2 week period (7 [4-10] vs 10 [5-16], p < 0.001), lower SD of glucose (3.8 [3.4-4.2] vs 4.1 [3.5-4.7] mmol/l, p = 0.017) and lower CV of glucose (38.0 [35.0-41.6] vs 41.8 [36.5-45.8], p < 0.001). These differences were also present in those with C-peptide 10-50 pmol/l and associations were independent of diabetes duration and estimated HbA1c in logistic regression analysis. Preserved C-peptide was also associated with lower rates of self-reported asymptomatic hypoglycaemia (8.0% vs 22.8% in the past month, p = 0.028). CONCLUSIONS/INTERPRETATION Preserved C-peptide secretion is associated with fewer low-glucose events and lower glucose variability on flash monitoring. This suggests that individuals with preserved C-peptide may more safely achieve intensive glycaemic targets.

中文翻译：

---

在患有1型糖尿病的成年人中，保留的C肽分泌与较少的低血糖事件和较低的葡萄糖变异性相关（监测快速血糖）。

目的/假设我们的目的是评估使用快速监测的1型糖尿病成年人中C肽分泌的持久性是否与较少的葡萄糖变异性和较少的低血糖事件相关。方法我们对一所大学教学医院糖尿病诊所的290名成年人进行了横断面研究，他们患有1型糖尿病，他们使用了闪光灯监测，并且在过去2年中可获得随机血浆C肽。在低C肽（<10 pmol / l）的个体和持续C肽（10-200 pmol / l或10-50 pmol / l）的个体之间比较了与闪光监测有关的变量。此外，评估了自我报告的低血糖症与C肽之间的关系（n = 167）。数据为中位数（四分位间距）。结果C肽分泌得以维持（10-200 pmol / l）的个体患糖尿病的时间较短（15 [9-24]比25 [15-34]岁，p <0.001），诊断时年龄较大（23 [14]） -28] vs 15 [9-25]岁，p <0.001），尽管该年龄组的当前年龄没有差异。保留的C肽与血糖<3.9 mmol / l的时间较短相关（3％[2-6％]对5％[3-9％]，p <0.001），每两周的低血糖事件较少（ 7 [4-10]和10 [5-16]，p <0.001），降低了葡萄糖的SD（3.8 [3.4-4.2] vs 4.1 [3.5-4.7] mmol / l，p = 0.017），并且降低了CV （38.0 [35.0-41.6]与41.8 [36.5-45.8]，p <0.001）。这些差异在C肽10-50 pmol / l的患者中也存在，并且相关性独立于糖尿病病程和logistic回归分析中估计的HbA1c。保留的C肽还与较低的自我报告的无症状低血糖发生率相关（过去一个月为8.0％比22.8％，p = 0.028）。结论/解释保留的C肽分泌与较少的低血糖事件和较低的血糖监测变异性有关。这表明具有保留的C肽的个体可以更安全地达到高血糖目标。