Postprandial serum C-peptide to plasma glucose ratio as a predictor of subsequent insulin treatment in patients with type 2 diabetes

Yoshifumi Saisho, Kinsei Kou, Kumiko Tanaka, Takayuki Abe, Hideaki Kurosawa, Akira Shimada, Shu Meguro, Toshihide Kawai, Hiroshi Itoh

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Type 2 diabetes is a progressive disease and most patients with type 2 diabetes eventually need insulin therapy. The objective of this study was to clarify C-peptide immunoreactivity (CPR), a marker of beta cell function, as a predictor of requirement for insulin therapy. We conducted a retrospective study of 579 consecutive subjects with type 2 diabetes who were admitted to our hospital from 2000 to 2007 and were able to be followed up for at least 6 months after discharge. Fasting and postprandial serum CPR and urinary CPR levels had been measured during admission. Information about insulin therapy at the last visit was obtained from medical records. At the last visit, 364 subjects (62.9%) were treated with insulin. Mean interval between discharge and the last visit was 4.5 ± 2.3 years. Serum and urine CPR levels at baseline were significantly associated with insulin treatment at the last visit (P<0.001 for all). Among CPR values, postprandial serum CPR to plasma glucose ratio (CPR index) showed the greatest area under the receiver operating characteristic (ROC) curve for insulin therapy. Multivariate logistic regression analysis evaluating the effect of postprandial CPR index adjusted for other confounders showed consistent results with unadjusted results. In conclusion, beta cell dysfunction is significantly correlated with future insulin therapy in patients with type 2 diabetes. Our study indicates that among CPR measurements, postprandial CPR index is the best predictive marker for future insulin therapy.

Original languageEnglish
Pages (from-to)315-322
Number of pages8
JournalEndocrine Journal
Volume58
Issue number4
DOIs
Publication statusPublished - 2011

Fingerprint

C-Peptide
Type 2 Diabetes Mellitus
Insulin
Glucose
Serum
Therapeutics
ROC Curve
Medical Records
Fasting
Retrospective Studies
Logistic Models
Regression Analysis
Urine

Keywords

  • Beta cell function
  • C-peptide
  • Insulin
  • Type 2 diabetes

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Postprandial serum C-peptide to plasma glucose ratio as a predictor of subsequent insulin treatment in patients with type 2 diabetes. / Saisho, Yoshifumi; Kou, Kinsei; Tanaka, Kumiko; Abe, Takayuki; Kurosawa, Hideaki; Shimada, Akira; Meguro, Shu; Kawai, Toshihide; Itoh, Hiroshi.

In: Endocrine Journal, Vol. 58, No. 4, 2011, p. 315-322.

Research output: Contribution to journalArticle

Saisho, Yoshifumi ; Kou, Kinsei ; Tanaka, Kumiko ; Abe, Takayuki ; Kurosawa, Hideaki ; Shimada, Akira ; Meguro, Shu ; Kawai, Toshihide ; Itoh, Hiroshi. / Postprandial serum C-peptide to plasma glucose ratio as a predictor of subsequent insulin treatment in patients with type 2 diabetes. In: Endocrine Journal. 2011 ; Vol. 58, No. 4. pp. 315-322.
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