Evolution of abnormal plasma glucagon responses to mixed-meal feedings in youth with type 1 diabetes during the first 2 years after diagnosis

Jennifer Sherr, Eva Tsalikian, Larry Fox, Bruce Buckingham, Stuart Weinzimer, William V Tamborlane, Neil H White, Ana Maria Arbelaez, Craig Kollman, Katrina J Ruedy, Peiyao Cheng, Roy W Beck, Diabetes Research in Children Network, Eva Tsalikian, Michael J Tansey, Julie Coffey, Joanne Cabbage, Sara Salamati, Nelly Mauras, Larry Fox, Kim Englert, Joe Permuy, Kaitlin Sikes, Bruce Buckingham, Darrell M Wilson, Paula Clinton, Kimberly Caswell, Stuart Weinzimer, William V Tamborlane, Jennifer Sherr, Amy Steffen, Kate Weyman, Melinda Zgorski, Eileen Tichy, Neil H White, Ana Maria Arbelaez, Lucy Levandoski, Angie Starnes, Jennifer Sherr, Eva Tsalikian, Larry Fox, Bruce Buckingham, Stuart Weinzimer, William V Tamborlane, Neil H White, Ana Maria Arbelaez, Craig Kollman, Katrina J Ruedy, Peiyao Cheng, Roy W Beck, Diabetes Research in Children Network, Eva Tsalikian, Michael J Tansey, Julie Coffey, Joanne Cabbage, Sara Salamati, Nelly Mauras, Larry Fox, Kim Englert, Joe Permuy, Kaitlin Sikes, Bruce Buckingham, Darrell M Wilson, Paula Clinton, Kimberly Caswell, Stuart Weinzimer, William V Tamborlane, Jennifer Sherr, Amy Steffen, Kate Weyman, Melinda Zgorski, Eileen Tichy, Neil H White, Ana Maria Arbelaez, Lucy Levandoski, Angie Starnes

Abstract

Objective: To examine the evolution of the dysregulated glucagon responses to mixed-meal tolerance tests (MMTTs) in youth with recent-onset type 1 diabetes (T1D).

Research design and methods: MMTTs were performed in 25 youth (9-18 years of age) with 1.5-12 months disease duration (year 1); 22 subjects were restudied 1 year later (year 2). Twenty nondiabetic (ND) control children were also studied.

Results: In T1D children, MMTT-stimulated increases in glucagon were significantly greater than that in ND children (median increments: year 1, 21 pg/mL [16-30]; year 2, 25 pg/mL [16-30]; ND, 9 pg/mL [5-16]; P = 0.001 and P < 0.001, respectively).

Conclusions: In comparison with ND control children, exaggerated plasma glucagon responses to mixed-meal feedings are observed in youth with T1D within the first 2 years of diagnosis. Further studies to determine whether suppression of these abnormal responses may help to improve glycemic control are warranted.

© 2014 by the American Diabetes Association.

Figures

Figure 1
Figure 1
Glucagon response to MMTT.

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