PubMed · 6508045
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M Dorner. 1984. [C-peptide].. https://pubmed.ncbi.nlm.nih.gov/6508045/
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OBJECTIVE: To investigate whether detectable C-peptide levels in type 1 diabetes is associated with a lower risk of diabetic ketoacidosis (DKA). RESEARCH DESIGN AND METHODS: We analyzed the Diabetes Control and Complications Trial publicly available data repository for the association between detectable stimulated C-peptide (>0.2 nmol/mL, measured annually) and DKA incidence over an average 6.5-year follow-up. We used crude and adjusted Andersen-Gill models for recurrent DKA events with time-dependent covariates. RESULTS: Of the 1,441 participants (53% male, median age 27 years), 129 (9%) experienced 180 DKA events. Of these events, 179 (99.44%) occurred after C-peptide was ≤0.2 nmol/L in the prior year and only 1 event occurred with C-peptide >0.2 nmol/L. C-peptide >0.2 nmol/L was associated with a DKA hazard ratio of 0.07 (95% CI 0.01-0.48; P = 0.007), consistent across adjusted models. CONCLUSIONS: Endogenous insulin production was significantly associated with lower DKA risk, suggesting that treatments preserving insulin production could decrease long-term DKA risk.
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Urinary C-peptide excretion was measured during the last trimester of pregnancy in 12 non-diabetic control women and in 32 women with gestational diabetes. The urine was sampled in two 12-hour periods between 06h00 and 18h00 and 18h00 and 06h00. At the end of the sampling period a fasting plasma sample was analysed for insulin, C-peptide, glycerol, free fatty acids and 3-hydroxybutyrate. The women with gestational diabetes had a significantly lower excretion of C-peptide during the daytime period. In this group women with diabetic heredity had lower C-peptide excretion during the day-time and the 24-hour period compared with women without diabetic heredity. In the non-diabetic group there was significant correlation between body mass index and urinary C-peptide during the night-time and the total 24-hour period. The gestational diabetic women had fasting plasma concentrations of glycerol, free fatty acids and 3-hydroxybutyrate acid that were significantly above the levels found in the control group.