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Evaluation of β-cell function in diabetic Taiwanese children using a 6-min glucagon test

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Abstract

This study evaluates the effects of glucagon 30 μg/kg (maximal 1 mg) on β-cell function in children by C-peptide determined before and 6 min after intravenous administration. From 1990 to 2005, 118 Taiwanese children with newly diagnosed diabetes mellitus (98 children with type 1 and 20 children with type 2) and 29 normal Taiwanese children were enrolled in this study. Fasting and 6-min post-glucagon C-peptide levels were analyzed. In the pre-pubertal group, the median fasting serum C-peptide levels were 0.2 and 0.8 nmol/l in type 1 diabetes and normal children, respectively. These levels rose to 0.3 and 1.9 nmol/l after glucagon stimulation. In the pubertal group, the median fasting serum C-peptide levels were 0.3, 1.0 and 0.9 nmol/l in type 1 diabetes, type 2 diabetes and normal children, respectively. They rose to 0.4, 2.5 and 2.7 nmol/l after glucagon stimulation. Both fasting and post-glucagon C-peptide levels in type 1 diabetes patients were significantly lower than those of normal children and children with type 2 diabetes. The optimal cut-off values to distinguish type 1 diabetes patients from those with type 2 as determined by the receiving operating characteristic curve were 0.7 and 1.1 nmol/l, respectively. The sensitivities of both C-peptide values were 93%. The post-glucagon C-peptide level was more powerful in distinguishing type 1 diabetes from type 2 diabetes with higher specificity (95% vs. 85%). The 6-min glucagon test is valuable in assessing β-cell function in children and can help pediatricians in the differential diagnoses of diabetes mellitus in children.

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Abbreviations

GAD65:

65-ka glutamic acid decarboxylase

IA-2:

tyrosine phosphatase

IAA:

insulin auto-antibodies

BMI:

body mass index

ROC:

Receiving Operating Characteristic

AUC:

areas under the ROC curves

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Authors and Affiliations

  1. Department of Pediatrics, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan

    Yi-Ching Tung, Jing-Sheng Lee, Wen-Yu Tsai & Pei-Hung Hsiao

  2. College of Medicine, National Taiwan University, Taipei, Taiwan

    Yi-Ching Tung, Jing-Sheng Lee, Wen-Yu Tsai & Pei-Hung Hsiao

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  1. Yi-Ching Tung
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  2. Jing-Sheng Lee
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  3. Wen-Yu Tsai
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  4. Pei-Hung Hsiao
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Correspondence to Wen-Yu Tsai.

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Tung, YC., Lee, JS., Tsai, WY. et al. Evaluation of β-cell function in diabetic Taiwanese children using a 6-min glucagon test. Eur J Pediatr 167, 801–805 (2008). https://doi.org/10.1007/s00431-007-0594-9

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  • DOI: https://doi.org/10.1007/s00431-007-0594-9

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