A Practical Review of C-Peptide Testing in Diabetes

Leighton, Emma; Sainsbury, Christopher; Jones, Gill

doi:10.1007/s13300-017-0265-4

Cited by 319 publications

(307 citation statements)

References 70 publications

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“…Several studies also demonstrated patients with lower c-peptide levels to exhibit an inclination toward insulin, whereas those with higher levels displayed a higher response rate to oral antidiabetics. Therefore, c-peptide may act as a crucial player in the designing of future guidelines related to diagnosis and clinical management of diabetes (12). While planning treatment for patients with T2DM, patient's current glucotoxicity, HbA1c levels, and clinical parameters are important and should be documented.…”

Section: Discussionmentioning

confidence: 99%

C-peptide Measurement may not be Necessary for Choosing a Treatment Modality in Type 2 Diabetes Mellitus: A Retrospective Analysis

Tazegül¹,

Öğüt²,

Bozoglan³

et al. 2017

Turk J Endocrinol Metab

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Turk J Endocrinol Metab 2017;21:68-71 C C--p pe ep pt ti id de e M Me ea as su ur re em me en nt t m ma ay y n no ot t b be e N Ne ec ce es ss sa ar ry y f fo or r C Ch ho oo os si in ng g a a T Tr re ea at tm me en nt t M Mo od da al li it ty y i in n T Ty yp pe e 2 2 D Di ia ab be et te es Purpuse: C-peptide (CP), generated during the cleavage of proinsulin to form insulin, serves as a specific marker of insulin-secreting beta cell function. Since CP is utilized to assess the secretion of insulin, it may act as an indicator in the treatment algorithm of diabetes. The present retrospective study aimed to demonstrate whether patients previously diagnosed with type-2 diabetes (T2DM) and on antidiabetic treatment received the recommended CP-guided treatment mentioned in the current guideline. Material and Method: A total of 179 patients, previously diagnosed with T2DM, were admitted to our outpatient clinic with complete clinical records and simultaneously measured fasting CP, glucose, and hemoglobin A1c (HbA1c) levels. We did not use the CP levels measured during the current course of treatment as a marker to designate or change treatment in the current study. Data were analyzed using the SPSS version 17.0. Results: The mean CP level for all patients was 2.71 ng/mL. Twelve patients (6.7%) had insufficient reservoir (CP < 0.5 ng/mL), 70 (39.1%) exhibited borderline reservoir (CP: 0.5-2.0 ng/mL), and 97 (54.2%) had sufficient reservoir of beta cells. All three groups were similar regarding age, gender, fasting glucose, and HbA1c. Metformin was more frequent in patients with sufficient reservoir, whereas all patients in the insufficient group were taking insulin. Conclusion: Although the literature on diabetes provides enough evidence on the use of CP in various indications, such as determining diabetes subtype, predicting treatment response, and residual beta cell reservoir, we conclude that it may have a limited use as factor deciding the choice of treatment in patients with T2DM. Keywords: C-peptide; insulin; type 2 diabetes mellitus Amaç: C-peptid beta hücre fonksiyonunu gösteren özgül bir belirteçtir ve tedavi algoritmasında kullanıma sahip olabilir. Bu retrospektif değerlendirmede, daha önce tanı almış ve tedavi altındaki tip 2 diyabet mellitus (T2DM) hastalarının tedavilerinin güncel kılavuzda yer alan CP güdümlü tedavi önerileri ile uyumunun incelenmesi amaçlandı. Gereç ve Yöntem: Bu retrospektif çalışmaya kliniğimize başvuran, klinik kayıtları ve eşzamanlı açlık plazma glukozu, c-peptid düzeyi ve HbA1c düzeyi ölçülmüş 179 T2DM hastası alındı. CP düzeyleri tedavi altında ölçüldü ve tedavi değiştirme veya yeni tedavi başlama amacıyla kullanılmadı. Analiz için SPSS 17.0 paket programı kullanıldı. Bulgular: Ortalama CP düzeyi tüm hastalarda 2.71 ng/mL saptandı. On iki hastada (%6.7) yetersiz rezervuar (CP<0.5 ng/mL), yetmiş hastada (%39.1) sınırda rezervuar (CP: 0.5-2 ng/mL) ve 97 hastada (%54.2) yeterli rezervuar bulunmuştur. Her üç grup da yaş, cinsiyet, açlık kan glukozu ve HbA1c açısından benzerdir. Yet...

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Section: Discussionmentioning

confidence: 99%

C-peptide Measurement may not be Necessary for Choosing a Treatment Modality in Type 2 Diabetes Mellitus: A Retrospective Analysis

Tazegül¹,

Öğüt²,

Bozoglan³

et al. 2017

Turk J Endocrinol Metab

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show abstract

“…Thus, C-peptide levels are associated with diabetes type and duration of disease, specifically a C-peptide level of less than 0.2 ng/ml is associated with a diagnosis of type 1 diabetes mellitus [11,15].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, C-peptide can be measured in blood or urine, during a fasting or stimulated sample. We used capillary blood to perform our assay and set the limit of 0,5ng/ml while authors who used urine [11,13,15] set their limit at 0,2 ng/ml to perform their classification. In all cases, it should be taken into account that the presence of large numbers of antiinsulin antibodies that bind both proinsulin and c-peptide can give a falsely high C-peptide reading.…”

Section: Discussionmentioning

confidence: 99%

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Basic C-peptidemia and Diabetic Patients Classification

Patricia¹,

Pierre²,

Joël-Brice³

et al. 2017

SJCM

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Diabetes is a real public health problem in the world. In Africa in general and in Côte d'Ivoire in particular, the management of diabetes is complicated by socio-economic difficulties. After the diagnosis of diabetes, its typing is carried out on the basis of clinical criteria. With the discovery of many subgroups of diabetes especially in Africa, the classification of diabetes is made difficult. This difficulty may raise questions about the adequacy of the therapeutic treatment of patients. The purpose of this study was to study mainly the contribution of basal C-peptidemia in the typing of diabetic subjects. The material concerned a population of 220 diabetics who carried out their peptide C assay and monitored at the Yopougon-ABIDJAN University and Hospital Center. Basal C-Peptidemia was assayed by competitive radio-immunoassay using the kit CIS -BIO Shering. The results revealed that the classification based on clinical signs was improved after the C-peptide assay. Indeed, after C-peptidemia, type 1 diabetics with low C-peptidemia (<0.5 ng/ml) and type 2 diabetics with normal Cpeptidemia (0.5 ng/ml to 3 ng/ml). In conclusion, the determination of peptide C appears as an undeniable tool for better classification of diabetic patients. The results of C-peptidemia would direct the practitioner towards a more adequate treatment in the patients studied.

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“…Unsurprisingly, insulin therapy is another predictor of worse response to bariatric surgery . In T2DM, insulin is used (ideally) when beta cells fail at an advanced phase of the disease.…”

Section: Predictors Of Long‐term Outcomesmentioning

confidence: 99%

Metabolic surgery for the treatment of type 2 diabetes in patients with BMI lower than 35 kg/m²: Why caution is still needed

Halpern

Mancini

2019

Obesity Reviews

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Summary Bariatric surgery has shifted from being a risky procedure to an evidence‐based one, with proven benefits on all‐cause mortality, cardiovascular disease, cancer, and diabetes control. The procedure has an overall positive result on type 2 diabetes mellitus (T2DM), with a substantial number of patients achieving disease remission. This has resulted in several studies assessing possible weight‐independent effects of bariatric surgery on glycemic improvement, in addition to recommendation of the procedure to patients with class 1 obesity and T2DM, for whom the procedure was classically not indicated, and adoption of a new term, “metabolic surgery,” to highlight the overall metabolic benefit of the procedure beyond weight loss. Recently, the Diabetes Surgery Summit (DSS) has included metabolic surgery in its T2DM treatment algorithm. Although the discussion brought by this consensus is highly relevant, the recommendation of metabolic surgery for patients with uncontrolled T2DM and a body mass index of 30 to 35 kg/m2 still lacks enough evidence. This article provides an overall view of the metabolic benefits of bariatric/metabolic surgery in patients with class 1 obesity, compares the procedure against clinical treatment, and presents our rationale for defending caution on recommending the procedure to less obese individuals.

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A Practical Review of C-Peptide Testing in Diabetes

Cited by 319 publications

References 70 publications

C-peptide Measurement may not be Necessary for Choosing a Treatment Modality in Type 2 Diabetes Mellitus: A Retrospective Analysis

C-peptide Measurement may not be Necessary for Choosing a Treatment Modality in Type 2 Diabetes Mellitus: A Retrospective Analysis

Basic C-peptidemia and Diabetic Patients Classification

Metabolic surgery for the treatment of type 2 diabetes in patients with BMI lower than 35 kg/m²: Why caution is still needed

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A Practical Review of C-Peptide Testing in Diabetes

Cited by 319 publications

References 70 publications

C-peptide Measurement may not be Necessary for Choosing a Treatment Modality in Type 2 Diabetes Mellitus: A Retrospective Analysis

C-peptide Measurement may not be Necessary for Choosing a Treatment Modality in Type 2 Diabetes Mellitus: A Retrospective Analysis

Basic C-peptidemia and Diabetic Patients Classification

Metabolic surgery for the treatment of type 2 diabetes in patients with BMI lower than 35 kg/m2: Why caution is still needed

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Product

Resources

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Metabolic surgery for the treatment of type 2 diabetes in patients with BMI lower than 35 kg/m²: Why caution is still needed