Serum c-peptide level in newly diagnosed Bangladeshi adults with type 2 diabetes mellitus

A. K. M. Saber Ahmed,A. F. M. Nazmul-Islam,Mohammad Shofiullah,A. B. M. Kamrul-Hasan,Mohammed Ruhul-Kabir,Habibur Rahman

doi:10.4038/sjdem.v9i2.7395

Abstract

C-peptide is produced in equimolar amounts to insulin and is the best measure of endogenous insulin secretion. This cross-sectional study was conducted in a tertiary hospital of Bangladesh from January 2016 to December 2017 to assess fasting serum c-peptide as a marker of the endogenous insulin secretory capacity in newly diagnosed subjects with type 2 diabetes mellitus (T2DM). 60 newly diagnosed T2DM subjects were investigated along with 30 age-sex matched healthy controls. Fasting c-peptide was significantly higher in T2DM subjects than controls (8.97±5.96 vs. 1.69±0.66 ng/ml). None of the T2DM subjects had subnormal c-peptide, 19 (32%) had normal c-peptide, and 41 (68%) of them had elevated c-peptide levels. Higher fasting plasma glucose (FPG), plasma glucose 2-hours after 75gm oral glucose tolerance test (PG 2H-OGTT) and HbA1c levels were observed in T2DM subjects with elevated c-peptide in comparison to T2DM subjects having normal c-peptide. In T2DM subjects, c-peptide showed significant positive correlations with body mass index (BMI), FPG, PG 2H-OGTT, and HbA1c. This study found higher levels of fasting c-peptide in newly diagnosed T2DM in comparison to nondiabetic controls. None of the T2DM subjects had a subnormal c-peptide level.

Highlights

Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both
The type 2 diabetes mellitus (T2DM) group and control group subjects did not differ in respect of age, sex, and serum creatinine levels
T2DM subjects had a higher frequency of first-degree relatives with T2DM; body mass index (BMI) and waist-to-hip ratio was higher in the T2DM group than the control group

Summary

Introduction

Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. More than 90% of subjects with DM worldwide have type 2 diabetes (T2DM) [1]. Though insulin resistance in the liver & muscle and β-cell failure represent the core pathophysiological defects in T2DM, it now is recognized that the β-cell failure occurs much earlier and is more severe than previously thought [2]. In Asia, the T2DM phenotype appears to be somewhat different from that in the western countries with a younger age of onset and with lower BMI while associated with greater visceral adiposity and reduced insulin secretory capacity [3]. Many studies have evaluated serum c-peptide as a marker of insulin secretion in T2DM subjects [4,5,6,7,8].

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Results

Conclusion