Context: Insulin sensitivity (SI) varies with age in Type 1 diabetes (T1D).
Objective: To compare postprandial glucose turnover and insulin sensitivity between adolescents and adults with T1D.
Design: Cross-sectional comparison.
Setting: Clinical Research Unit.
Patients: 21 early adolescents with T1D (T1D-adol) [12F; age: 11.5 ± 0.5yrs.; BMI: 19 ± 2 kg/m2], 13 adults with T1D (T1D-adult) [5F; 37.8 ± 9.1yrs.; BMI: 27 ± 2 kg/m2] and 14 anthropometrically matched adults without diabetes (ND) [7F; 26.9 ± 7.0yrs.; BMI: 25 ± 2.5 kg/m2].
Procedure: Triple-tracer mixed meal study and oral glucose models.
Main Outcome Measure: SI between T1D-adol and T1D-adult.
Results: Post-prandial glucose excursions were not different in T1D-adol vs T1D-adult (p = 0.111) but higher than in ND (p < 0.01). Insulin excursions were also similar in T1D-adol vs. T1D-adult (p = 0.600) and they were both lower (p < 0.05) compared to ND, while glucagon excursions were lower (p < 0.01) in T1D-adol than in T1D-adult and ND. Integrated rates of endogenous glucose production and glucose disappearance were lower in T1D-adol than in T1D-adult and in ND vs. T1D-adult but did not differ between T1D-adol and ND. Meal glucose appearance did not differ between groups. Insulin sensitivity (SI) in T1D-adol vs ND was similar (p = 0.299). However, SI was higher in T1D-adol and ND vs. T1D-adult (p < 0.01).
Conclusions: We report differences in parameters of postprandial glucose turnover and insulin sensitivity between adults and early adolescents with T1D that could, at least in part, be due to the shorter duration of diabetes among T1D-adol. These data support the concept that over time with T1D endogenous glucose production increases and SI deteriorates.
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