Relation of Fasting C-peptide Level and Occurrence of Hypoglycemia at Insulin Initiation among Patients with Immune Mediated Diseases

Abstract

Background: Controlling diabetes is a challenging mission specifically in patients who have an immune-mediated disease. Hypoglycemia is one of the common complications especially during shifting from oral to insulin treatment. So, the Prediction of hypoglycemia may ease diabetes control. C-peptide may have a role in the occurrence of hypoglycemia. Aim of the study: To assess the relationship between baselines fasting Cpeptide (FCP) and hypoglycemia risk at basal insulin initiation in insulinnaïve people with type 2 diabetes. Patients and Methods: This study was a prospective study conducted on 60 subjects (their age ranging between 40 -60 years), in which they were divided into 2 groups: Group (A): patients group included 30 patients suffering from type 2 diabetes mellitus with a high level of plasma fasting c-peptide ( ≥ 2 nmol/L). Group (B): patients group included 30 patients suffering from type 2 diabetes mellitus with a low level of plasma fasting c-peptide (≤ 0.4 nmol/L). Overall Hypoglycemia, nocturnal, and severity of Hypoglycemia were assessed. All patients were selected from the internal medicine department and outpatient clinic (at both Al Hussein and Sayed Jalal University Hospitals). Results: the comparison between both groups at baseline and after 24 weeks was done regarding Hypoglycemia, overall Hypoglycemia, nocturnal, and severity of Hypoglycemia. Hypoglycemia was statistically significantly found in patients with low plasma fasting C-peptide rather than the patients who had high levels of plasma fasting C-peptide. Conclusion: Low fasting plasma C-peptide is associated with the risk of hypoglycemia in diabetic patients with the immune-mediated disease who started insulin therapy.

C‐peptide in diabetes: A player in a dual hormone disorder?

“…It is a key player in T2DM, metabolic syndrome, low high‐density lipoprotein‐cholesterol (HDL‐C), hypertriglyceridemia, and coronary heart disease (Reaven, 1995). “C‐peptide resistance” is an emerging term used to describe the reduced effectiveness of C‐peptide's protective functions in diabetes, hypertension, low HDL‐C, hypertriglyceridemia, and obesity (Bo et al, 2012; Khedr et al, 2022; Luzi et al, 2015). Efforts are being invested to better understand this phenomenon, but there is still a dearth of reports describing it.…”