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Pediatr Diabetes. 2016 Jun;17(4):274-80. doi: 10.1111/pedi.12280. Epub 2015 May 5.

C-peptide levels in pediatric type 2 diabetes in the Pediatric Diabetes Consortium T2D Clinic Registry.

Author information

1
Department of Pediatric Endocrinology, Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA.
2
Jaeb Center for Health Research, Tampa, FL, USA.
3
Pediatric Endocrinology, University of Florida, Gainesville, FL, USA.
4
Pediatric Endocrinology, Yale University, New Haven, CT, USA.
5
Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO, USA.
6
Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, MI, USA.

Abstract

OBJECTIVE:

To describe C-peptide levels in a large cohort of children with type 2 diabetes T2D and examine associations with demographic and clinical factors.

METHODS:

The Pediatric Diabetes Consortium (PDC) T2D Registry has collected clinical and biologic data from youth with T2D cared for at eight US Pediatric Diabetes Centers. In this study, we assessed C-peptide levels in 331 youth with T2D (mean age, 16.1 ± 2.5 yr; median T2D duration, 2.4 yr).

RESULTS:

Median (interquartile range) for 90 fasted C-peptide measurements was 3.5 ng/mL (2.3-4.8 ng/mL) [1.2 nmol/L (0.8-1.6 nmol/L)] and for 241 random non-fasted C-peptide measurements were 4.2 ng/mL (2.6-7.0 ng/mL) [1.4 nmol/L (0.9-2.3 nmol/L)]. C-peptide levels were lower with insulin therapy (p < 0.001), lower body mass index (p < 0.001), hemoglobin A1c (HbA1c) ≥9% (p < 0.001), and T2D duration ≥ 6 yr (p = 0.04). Among those with duration ≥6 yr being treated with insulin and with a HbA1c level ≥9.0% (75 mmol/L), 75% of the fasted and 80% of the non-fasted C-peptide values were above 0.2 nmol/L.

CONCLUSIONS:

In youth with T2D, a decline in C-peptide is associated with deterioration of metabolic control and the need for insulin treatment. C-peptide levels decrease over time. However, even insulin-treated patients with 6 or more years of T2D and elevated HbA1c levels retain substantial endogenous insulin secretion.

KEYWORDS:

C-peptide; Pediatric Diabetes Consortium; body mass index; clinical science; diabetes in childhood; glutamic acid decarboxylase; hemoglobin A1c; islet antigen-2; type 1 diabetes; type 2 diabetes

PMID:
25940861
DOI:
10.1111/pedi.12280
[Indexed for MEDLINE]
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