Type 1 diabetes is associated with loss of insulin release, which results in high blood sugars. In children and young adults this loss of insulin is known to happen quickly. After just a couple of years of having type 1 diabetes, most of this age group will make almost no insulin. Research is trying to find new treatments to slow down and even stop this insulin loss. Those developing type 1 diabetes after 30 years of age are rarely included in these trials- despite making up nearly half of all cases of type 1 diabetes. This is because, in this age group, the rate of insulin loss is unknown. Finding out this rate and factors that effect it is an important step towards including older individuals in trials.
We are also testing a new, simpler way of monitoring insulin loss by using a finger prick blood test, making it possible to conduct research from home rather than in hospital or a research clinic. Together, the answers to these questions aim to make it easier to develop new treatments for type 1 diabetes, as these studies could recruit many more people, using a much simpler and cheaper measure of insulin loss.
The study will recruit 196 adults aged 18 and over within 100 days of a clinical diagnosis of type 1 diabetes. We will compare the loss of insulin production of 135 participants diagnosed >30 years of age with 61 participants diagnosed 18 to 30 years of age.
All study procedures are carried out at home, with phone or video support from the research team.
Primary Outcome Measure:
- 12 month (Mixed Meal Tolerance Test) MMTT area under the curve (AUC) C-peptide. [Time Frame: 12 months]
- Rate of change of MMTT AUC C-peptide over 12 months assessed at baseline,6 and 12 months [Time Frame: 12 months]
Secondary Outcome Measures:
- 12 month C-peptide measured by: MMTT 120 minute plasma, MMTT 120 minute dried blood spot, home dried blood spot. [Time Frame: 12 months]
- Rate of change of C-peptide over 12 months assessed at baseline,6 and 12 months measured by: MMTT 120 minute plasma, MMTT 120 minute dried blood spot, home dried blood spot. [Time Frame: 12 months]
- Relationship of 120 minute MMTT C-peptide and blood spot C-peptide. [Time Frame: 12 months]
- Glucose variability & hypoglycemia as measured by continuous glucose monitoring (CGM) [Time Frame: 12 months]