A Cross-sectional Study to Assess Beta-Cell Function in Individuals with Recently Diagnosed Young-Onset Type 2 Diabetes Mellitus and Its’ Complications

Shamharini Nagaratnam; Subashini Rajoo; Mohamed Badrulnizam   Long Bidin; Nur Shafini  Che Rahim; Sangeetha  Tharmathurai; Masita  Arip; Yee Ming  Ching; Siew Hui  Foo

doi:10.15605/jafes.038.02.13

Authors

Shamharini Nagaratnam Selayang Hospital, Selangor, Malaysia https://orcid.org/0000-0002-1505-3397
Subashini Rajoo Hospital Kuala Lumpur, Malaysia
Mohamed Badrulnizam Long Bidin Kuala Lumpur Hospital, Malaysia
Nur Shafini Che Rahim Kuala Lumpur Hospital, Malaysia https://orcid.org/0000-0002-7774-6818
Sangeetha Tharmathurai Kuala Lumpur Hospital, Malaysia https://orcid.org/0000-0002-7590-531X
Masita Arip National Institute of Health, Selangor, Malaysia
Yee Ming Ching https://orcid.org/0000-0001-5567-1344
Siew Hui Foo Selayang Hospital, Selangor, Malaysia https://orcid.org/0000-0002-5635-4508

DOI:

https://doi.org/10.15605/jafes.038.02.13

Keywords:

Type 2 diabetes mellitus, Young onset, Beta cell function, C-peptide, Glucagon stimulation test

Abstract

Objective. The primary objective was to assess beta-cell function of recently-diagnosed young-onset type 2 diabetes mellitus (T2DM) individuals using basal and stimulated C-peptide levels. The secondary objective was to examine the association between C-peptide with metabolic factors and diabetes complications.

Methodology. A cross-sectional study was conducted for young-onset T2DM individuals aged 18-35 years with a disease duration of not more than 5 years. Plasma C-peptide was measured before and after intravenous glucagon injection. Demographic data, medical history and complications were obtained from medical records and clinical assessment. Continuous data were expressed as median and interquartile range (IQR). Categorical variables were described as frequency or percentage. Multivariable linear regression analysis was used to determine factors associated with C-peptide levels.

Results. 113 participants with young-onset T2DM with a median (IQR) age of 29.0 (9.5) years and 24 (36) months were included in this study. The median (IQR) basal and stimulated C-peptide was 619 (655) pmol/L and 1231 (1024) pmol/L. Adequate beta-cell function was present in 78-86% of the participants based on the basal and stimulated C-peptide levels. We found hypertension, obesity and diabetic kidney disease (DKD) to be independently associated with higher C–peptide levels. In contrast, females, smokers, those on insulin therapy and with longer duration of disease had lower C–peptide levels.

Conclusion. Most recently diagnosed young-onset T2DM have adequate beta-cell function. Elevated C-peptide levels associated with obesity, hypertension and diabetic kidney disease suggest insulin resistance as the key driving factor for complications.

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Author Biographies

Shamharini Nagaratnam, Selayang Hospital, Selangor, Malaysia

Endocrine Unit, Department of Medicine

Subashini Rajoo, Hospital Kuala Lumpur, Malaysia

Endocrine Unit

Mohamed Badrulnizam Long Bidin, Kuala Lumpur Hospital, Malaysia

Endocrine Unit

Nur Shafini Che Rahim, Kuala Lumpur Hospital, Malaysia

Department of Pathology

Sangeetha Tharmathurai, Kuala Lumpur Hospital, Malaysia

Department of Ophthalmology

Masita Arip, National Institute of Health, Selangor, Malaysia

Allergy and Immunology Centre, Institute of Medical Research (IMR)

Siew Hui Foo, Selayang Hospital, Selangor, Malaysia

Endocrine Unit, Department of Medicine

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