The ratio of postprandial to fasting C-peptide may be utilized as a novel indicator of pancreatic beta-cell plasticity
Keywords:
Beta-cell function, C peptide, Glycemic control, Hba1c, Insulin initiation, Type 2 diabetesAbstract
It's crucial to pinpoint which individuals with type 2 diabetes (T2D) will need insulin therapy to tailor their treatment effectively. C-peptide serves as a key indicator of how much insulin the body is producing on its own, helping us evaluate β-cell function. While both fasting and postprandial C-peptide levels shed light on how the pancreas is working, the ratio of these two measurements (known as the postprandial to fasting C-peptide ratio, or P/F C-peptide ratio) might provide even better insights into long-term insulin needs.
Methods: This study aims to explore how useful the P/F C-peptide ratio is in predicting insulin requirements for patients with T2D. A group of individuals diagnosed with T2D underwent testing for both fasting and postprandial C-peptide levels. We calculated the P/F C-peptide ratio for each participant. We also gathered clinical information, such as how long they’ve had diabetes, their HbA1c levels, Body Mass Index (BMI), and current medications. Participants were followed over time to see who progressed to needing insulin therapy. We used logistic regression models to analyze the relationship between the P/F C-peptide ratio and the later need for insulin, while accounting for other influencing factors.
Results: Those with a lower P/F C-peptide ratio were significantly more likely to start insulin therapy during the follow-up period. This ratio remained a strong independent predictor even after adjusting for age, duration of diabetes, and glycemic control. Receiver Operating Characteristic (ROC) analysis showed that the P/F C-peptide ratio had moderate to high sensitivity and specificity in forecasting insulin use.
Conclusion: The postprandial to fasting C-peptide ratio seems to be a promising and practical biomarker for evaluating β-cell function and predicting insulin needs in T2D patients. Integrating this ratio into routine assessments could enhance patient care.
