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Diabet Med. 2016 Nov;33(11):1564-1568. doi: 10.1111/dme.13186. Epub 2016 Aug 8.

Stimulated urine C-peptide creatinine ratio vs serum C-peptide level for monitoring of β-cell function in the first year after diagnosis of Type 1 diabetes.

Author information

1
Diabetes Research Group, Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK. tatovicd@cardiff.ac.uk.
2
Institute for Life Sciences, Swansea University, Swansea, UK.
3
Department of Immunobiology, Faculty of Life Sciences and Medicine, King's College London, London, UK.
4
Diabetes Research Group, Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK.

Abstract

AIMS:

To determine if urine C-peptide/creatinine ratio is a useful tool for monitoring β-cell function in new-onset Type 1 diabetes.

METHODS:

Data were obtained from a prospective immunomodulation study in people with Type 1 diabetes ≤ 3 months from diagnosis, with a standard mixed-meal tolerance test and measurement of urine C-peptide/creatinine ratio carried out at 0, 3, 6, 9 and 12 months. The change in the insulin-dose-adjusted HbA1c level was also correlated with the change in serum/urine C-peptide level during the 12-month follow-up period.

RESULTS:

A significant reduction in urine C-peptide/creatinine ratio, measured after a mixed-meal, was reached at 9 months (-45.4%), whilst the reduction in stimulated serum C-peptide level reached significance after 3 months (-54.7%) in placebo-treated participants. Neither change in stimulated serum C-peptide nor change in urine C-peptide level correlated with each other, and nor did change in insulin-dose-adjusted HbA1c level in the first 6 months, but all measures correlated significantly in the second half of the 12-month follow-up period.

CONCLUSION:

Mixed-meal-stimulated urine C-peptide/creatinine ratio was similar to, although less sensitive than, stimulated serum C-peptide level in monitoring β-cell function during the first year after diagnosis. Because the former is significantly less invasive, it warrants inclusion in further studies in Type 1 diabetes and may represent an attractive alternative outcome measure in cohort studies and in children.

PMID:
27425010
DOI:
10.1111/dme.13186
[Indexed for MEDLINE]

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