An Association of Fasting C-Peptide Levels and Vascular Complications in Chronic Type 2 Diabetes Mellitus Patients

Numerous biochemical markers are being used in clinical practice for the prediction and prognostication of vascular complications among non diabetic individuals. Of late, fasting C-peptide levels is being investigated for its possible role in the prediction and protection of vascular complications of diabetes. It is also being explored for its protective role in prevention of vascular complications among patients with diabetes mellitus. Aim: The present study was undertaken with an objective to assess the strength of association of fasting C-peptide levels in the development of microvascular and macrovascular complications. Materials and Methods: An observational cross-sectional study involving 100 subjects with Type 2 Diabetes mellitus (T2DM) having an objective evidence of vascular complications were included into the study. The study period was 18 months from October 2017 to September 2019. After an overnight fasting of atleast 12 hours, C-peptide level estimation was done by Electro-Chemiluminescence Assay (ECLA) method. Results: The overall mean fasting C-peptide level among subjects with microvascular complications (0.73±0.55 ng/mL) was significantly decreased compared with subjects having macrovascular complications (2.44±0.72 ng/mL, with p-value being <0.001). Among microvascular complications, the mean fasting C-peptide level was least in subjects with diabetic retinopathy (0.64±0.35 ng/mL). Among patients with macrovascular complications, preserved C-peptide levels were observed in subjects with ischemic heart disease (2.35±0.75 ng/mL). Conclusion: Fasting serum C-peptide levels are significantly reduced among subjects with chronic T2DM having microvascular complications when compared to macrovascular complications. Also, with preserved serum levels, fasting C-peptide might have a protective role in the prevention of macrovascular complications among subjects with diabetes mellitus.