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Investigators aim to further the understanding of the various factors that govern the progression of beta-cell death in individuals recently diagnosed with Type 1 diabetes (T1D). Specifically, the investigators wish to examine the utility of plasma-induced signatures and other measures as predictive biomarkers for the rate of C-peptide decline in individuals with recent onset T1D. Persistent C-peptide in individuals with T1D reflects some degree of β-cell function and is clinically associated with a reduction in both severe hypoglycemic events and microvascular complications such as diabetic nephropathy and retinopathy. There is significant heterogeneity in the rate of C-peptide decline in individuals with T1D, reflective of the complex disease process. For example, ~10% of individuals have no discernable fall in stimulated C-peptide after two years from clinical diagnosis as compared to other individuals with very rapid C-peptide decline. It is currently impossible to predict how long, and to what extent, someone will have residual C-peptide production. This complicates clinical management but also the design and interpretation of T1D β-cell preservation trials. The "gold standard" outcome measure of any T1D β-cell preservation trial is the stimulated C-peptide to a mixed meal tolerance test (MMTT). Given the variability in this measure, intervention studies must include more subjects over a longer period of time. This slows the rate of scientific discovery and increases cost. This study aims to define the governing mechanisms of post-onset T1D disease trajectory. Understanding the trajectory of the disease may lead to the development of biomarkers to predict disease progression and therapies that could reverse or prevent the development of Type 1 diabetes.
Predicting the honeymoon period [ Time Frame: 3 years (the duration of the study) ]
To determine if that plasma-induced transcription has utility in predicting the post-onset disease trajectory in individuals with recent onset type 1 diabetes.
Secondary Outcome Measures :
Establishing the relationship between baseline inflammation and other measures [ Time Frame: 3 years (the duration of the study) ]
establishing the relationship between baseline inflammation and other clinical, metabolic, genetic, hematologic, and immunologic parameters in those newly diagnosed with T1D as a means of better understanding disease progression
Biospecimen Retention: Samples With DNA
We will be collecting stool samples as well as blood samples. Blood samples will be analyzed for HLA haplotype (a genetic sequence related to type 1 diabetes susceptibility), RNA, plasma-induced signature, simulated c-peptide by 2 hour MMTT, diabetes autoantibodies, CBC with differential, HbA1c and serum and plasma for storage. Specimens will be used and stored until none is left or until 10 years after the close of the study. Research records and data will be stored until 10 years after the close of the study.
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Layout table for eligibility information
Ages Eligible for Study:
6 Years to 17 Years (Child)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Males and females between the ages of 6 and 17 years who were diagnosed with type 1 diabetes within the 3 months prior to their first study visit, who are being treated at Children's Hospital of Wisconsin.
Males and females 6-17 years of age with a clinical diagnosis of T1D
T1D diagnosis date between 1-3 months at the time of study visit 2 (baseline visit)
Treatment naïve of any immunomodulatory agent
Receiving routine out-patient diabetes care at the CHW Diabetes Clinic
Presence of severe, active disease that requires the use of chronic medication, with the exception of well-controlled autoimmune thyroiditis/hypothyroidism or celiac disease that is well-controlled on a gluten free diet.
Diabetes other than T1D
Chronic illness known to affect glucose metabolism
Psychiatric impairment, with the exception of well-controlled depression or anxiety, that will affect the ability to participate in the study
Female participants of child-bearing age with reproductive potential must not be knowingly pregnant
Any condition that, in the investigator's opinion, may compromise study participation or may confound the interpretation of the study results