Quantifying beta cell function in the preclinical stages of type 1 diabetes.
Quantifying beta cell function in the preclinical stages of type 1 diabetes.
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DOI：
10.1007/s00125-023-06011-5
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发表时间：
2023-12
期刊：
影响因子：
8.2
通讯作者：
Dayan, Colin
中科院分区：
文献类型：
--
作者：
Galderisi, Alfonso;Carr, Alice L. J.;Martino, Mariangela;Taylor, Peter;Senior, Peter;Dayan, Colin
关键词：
临床上有症状的1型糖尿病(3期1型糖尿病)出现症状前阶段，特征是在胰岛自身免疫开始后，功能性β细胞团逐渐丧失，在OGTT期间有(阶段2)或没有(阶段1)可测量的血糖变化。确定可以纵向跟踪β细胞功能变化的代谢测试对于跟踪疾病进展和衡量疾病修正干预措施的效果至关重要。在这篇综述中，我们描述了在1型糖尿病早期症状前阶段发生的与胰岛素分泌和胰岛素敏感性有关的代谢变化，以及从可用的测试中可以得出的可测量的结果。我们还讨论了使用代谢模型来识别胰岛素分泌和敏感性，以及在动态试验(如OGTT)中可测量的变化。最后，我们回顾了风险指数和微创措施的作用，例如那些源自连续血糖监测的措施。网上版本载有可在10.1007/s00125-023-06011-5下载的数字幻灯片。
Clinically symptomatic type 1 diabetes (stage 3 type 1 diabetes) is preceded by a pre-symptomatic phase, characterised by progressive loss of functional beta cell mass after the onset of islet autoimmunity, with (stage 2) or without (stage 1) measurable changes in glucose profile during an OGTT. Identifying metabolic tests that can longitudinally track changes in beta cell function is of pivotal importance to track disease progression and measure the effect of disease-modifying interventions. In this review we describe the metabolic changes that occur in the early pre-symptomatic stages of type 1 diabetes with respect to both insulin secretion and insulin sensitivity, as well as the measurable outcomes that can be derived from the available tests. We also discuss the use of metabolic modelling to identify insulin secretion and sensitivity, and the measurable changes during dynamic tests such as the OGTT. Finally, we review the role of risk indices and minimally invasive measures such as those derived from the use of continuous glucose monitoring. The online version contains a slideset of the figures for download available at 10.1007/s00125-023-06011-5.
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