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Errors are likely to result when diagnosing type 1 or 2 diabetes based on a measurement of basal fasting C-peptide (CP), and 6-minute post-glucagon-stimulated C-peptide (CPS). Lead author Farhad Zangeneh, MD, Mayo Clinic and Mayo Medical School, Rochester, Minn, reported the finding here on May 16th at the American Association of Clinical Endocrinologists 12th Annual Meeting and Clinical Congress.
Using data gathered from the population-based Rochester Diabetic Neuropathy Study, Dr. Zangeneh’s team followed 317 patients with diabetes who participated in a longitudinal follow-up study for a mean duration of 7.1 years (range 1.9 to 16.4 years).
CP and CPS averaged 0.58 and 1.06 nmol/L at the beginning of the study, and decreased to 0.41 and 0.71 nmol/L respectively by its end. “[During the course of the investigation], considerable variability was noted among individual study subjects,” stated Dr. Zangeneh.
Eighteen study patients had CP or CPS increment measurements (CPI) less than 0.17 or 0.07 nmol/L on at least one occasion, while 3 of the 16 patients, on subsequent follow-up visits, had CPI values greater than those thresholds.
“Despite the variability, there is insulin-production decline over time, so the data reaffirm the [homeostasis model assessment] of insulin decline. But since the decrease does not occur in all patients, and since it is highly variable, errors are likely to result when a single measurement of fasting CP and CPS is used to distinguish between type 1 and type 2 diabetes,” said Dr. Zangeneh.
C-peptide increment has long been used as surrogate markers to estimate insulin secretion and to distinguish between type 1 and type 2 diabetes.
AACE:[Study title: The Natural History of Insulin Secretion in Patients With Type 2 Diabetes. Abstract 65]
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FACT: For each risk factor present, the risk of cardiovascular death is about three times greater in people with diabetes as compared to people without the condition. IDF