Abstract 71: Preserved beta cell function in long standing type 1 diabetes mellitus

Abstract

Background: Maturity onset diabetes of young (MODY) may be misdiagnosed as type 1 or type 2 diabetes mellitus and there may be an overlap between MODY and type 1 diabetes. The presence of persistent endogenous insulin, after the “honey-moon period” has ended, should lead to evaluation of secondary causes of diabetes including MODY.Aim: To identify subjects with preserved beta cell function; utilizing urinary C-peptide/creatinine ratio (UCPCR) in those, who have been diagnosed and treated as Type 1 diabetes mellitus.Methodology: Hospital based cross sectional study, between February 2019 and February 2021 in 100 Subjects diagnosed as Type 1 DM for more than 3 years.Results: Mean age and duration of DM 14.17 years and 5.3years respectively. Among 18 who had family history of D.M, 7 subjects had 3 generation involvement. GAD antibodies (68%) were more prevalent compared to IA 2 antibodies (56%). 49% had presence of both Anti GAD and IA2 auto antibodies. Mean UCPCR was 0.17. UCPCR >0.2 (suggestive of preserved endogenous insulin secretion) was present in 8 subjects among study population. Among these 8 subjects, 4 subjects had history of DKA episodes, 3 subjects had family history of D.M. 3 subjects did not have either of the auto antibodies. Compared to UCPCR <0.2, subjects with UCPCR >0.2 had statistically significant lower Hba1c (p=0.005), high UCPCR values (p=0.001), high MODY probability scores (p=0.004).Conclusions: UCPCR can be used as a screening tool to identify cases who need further evaluation for secondary causes, including genetic testing for MODY.