This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Measurement of -cell function can serve as the primary end point of clinical trials attempting to slow or stop -cell destruction. There are numerous ways to assess this as the -cell responds to various oral and IV secretagogues. The most commonly used tests in clinical practice are the C-peptide response to either an oral mixed meal (Mixed Meal Tolerance Test, MMTT) and to administration of IV glucagon (Glucagon Stimulation Test, GST). These tests differ in duration, type and route of stimulus, degree of hyperglycemia induced and subject and investigator burden. Further, it is not known whether there are differences in reliability between these two tests. Thus, determination of reliability of C-peptide measures under these test conditions will be the primary outcome of this study. Additional analyses will describe the nature of the relationship between the two tests using a linear or non-linear regression model as appropriate. Models will also adjust for variables such as the source of the data, age, sex and duration of diabetes and glucose value. Approximately 120 participants at multiple centers will be asked to undergo four tests: two MMTT and two GST, 3-10 days apart. Subjects will be studied under the auspices of Diabetes TrialNet.
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