Open AccessPostprandial C ‐peptide to glucose ratio as a predictor of β‐cell function and its usefulness for staged management of type 2 diabetes
Author(s) -
Lee Eun Young,
Hwang Sena,
Lee Seo Hee,
Lee Yongho,
Choi A Ra,
Lee Youngki,
Lee ByungWan,
Kang Eun Seok,
Ahn Chul Woo,
Cha Bong Soo,
Lee Hyun Chul
Publication year - 2014
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12187
Subject(s) - medicine , postprandial , type 2 diabetes , glycated hemoglobin , diabetes mellitus , glycemic , metformin , body mass index , endocrinology , insulin , c peptide , gastroenterology
Aims/Introduction Type 2 diabetes is characterized by progressive deterioration of β‐cell function. Recently, it was suggested that the C ‐peptide‐to‐glucose ratio after oral glucose ingestion is a better predictor of β‐cell mass than that during fasting. We investigated whether postprandial C ‐peptide‐to‐glucose ratio ( PCGR ) reflects β‐cell function, and its clinical application for management of type 2 diabetes. Materials and Methods We carried out a two‐step retrospective study of 919 K orean participants with type 2 diabetes. In the first step, we evaluated the correlation of PCGR level with various markers for β‐cell function in newly diagnosed and drug‐naïve patients after a mixed meal test. In the second step, participants with well‐controlled diabetes (glycated hemoglobin <7%) were divided into four groups according to treatment modality (group I: insulin, group II: sulfonylurea and/or dipeptityl peptidase IV inhibitor, group III: metformin and/or thiazolidinedione and group IV: diet and exercise group). Results In the first step, PCGR was significantly correlated with various insulin secretory indices. Furthermore, PCGR showed better correlation with glycemic indices than homeostatic model assessment of β‐cell function ( HOMA ‐β). In the second step, the PCGR value significantly increased according to the following order: group I, II , III , and IV after adjusting for age, sex, body mass index and duration of diabetes. The cut‐off values of PCGR for separating each group were 1.457, 2.870 and 3.790, respectively ( P < 0.001). Conclusions We suggest that PCGR might be a useful marker for β‐cell function and an ancillary parameter in the choice of antidiabetic medication in type 2 diabetes.