Increase in C-peptide levels after resolution of hyperglycemia in patients with type 2 diabetes mellitus: Myths or facts?

Increase in C-peptide levels after resolution of hyperglycemia in patients with type 2 diabetes mellitus: Myths or facts?

Aim: Long term control of glucotoxicity was shown to increase the secretion of insulin and C-peptide (Cp). We aimed to investigatethe change in Cp levels after short term glycemic control in patients with uncontrolled type 2 diabetes mellitus (DM).Material and Methods: Patients with type 2 DM with uncontrolled hyperglycemia were included. Basal fasting Cp levels weremeasured both at admission (Cp-admission) and after control of hyperglycemia prior to discharge (Cp-discharge). Cp-differencewas calculated as (Cp-discharge)-(Cp-admission). The patients were divided as group 1 (positive Cp-difference) and group 2(negative Cp-difference), and group A (Cp-difference ≥+0.5) and group B (Cp-difference ≤-0.5).Results: Of the patients (n=123), 61.8% had positive Cp-difference, and mean Cp-differences were 0.16 (±1.59), 0.96 (±1.03), and-1.11 (±1.51) in all patients, group1 and 2; respectively (p=0.001). Mean body weight, creatinine and Cp-discharge were higher ingroup 1(p=0.045, p=0.013, p=0.001; respectively). Mean age, body mass index(BMI), diabetes duration, hospitalization, proteinuria,fasting and postprandial glucose, glucose-discharge, HbA1c, lipids, TSH, free T4, Cp-admission were similar in group 1 and 2.Cpdifference was correlated positively with Cp-discharge(p=0.001), negatively with Cp-admission (p=0.001). There were no significantdifferences between subgroups (age, BMI, diabetes duration, use of secretagogue, diabetic ketaoacidosis history, HbA1c (

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  • 1. Forst T, Kunt T, Pohlmann T, et al. Biological activity of C-peptide on the skin microcirculation in patients with insulin-dependent diabetes mellitus. J Clin Invest 1998;101:2036-41.
  • 2. Nakamura H, Jinzu H, Nagao K, et al. Plasma amino acid profiles are associated with insulin, C-peptide and adiponectin levels in type 2 diabetic patients. Nutr Diabetes;1:4:e133.
  • 3. Lappas M, Jinks D, Ugoni A, et al. Postpartum plasma C-peptide and ghrelin concentrations are predictive of type 2 diabetes in women with previous gestational diabetes mellitus. J Diabetes 2014.
  • 4. Pipi E, Marketou M, Tsirogianni A. Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adults in relation to type 1 and type 2 diabetes mellitus. World J Diabetes 2014;5:505-10.
  • 5. Tabák AG, Jokela M, Akbaraly TN, et al. Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study. Lancet. 2009;373:2215-21.
  • 6. Kosaka K, Akanuma Y. Heterogeneity of plasma IRI responses in patients with IGT. Diabetologia 1980;18:347-48.
  • 7. Kadowaki T, Miyake Y, Hagura R, et al. Risk factors for worsening to diabetes in subjects with impaired glucose tolerance. Diabetologia 1984;26:44-9.
  • 8. U.K. Prospective Diabetes Study Group. U.K. prospective diabetes study 16. Overview of 6 years’ therapy of type II diabetes: a progressive disease. Diabetes 1995;44:1249-5.
  • 9. Sakuraba H, Mizukami H, Yagihashi N, et al. Reduced beta-cell mass and expression of oxidative stressrelated DNA damage in the islet of Japanese Type II diabetic patients. Diabetologia 2002;45:85-96.
  • 10. Butler AE, Janson J, Bonner-Weir S, et al.β-Cell deficit and increased β-cell apoptosis in humans with type 2 diabetes. Diabetes. 2003;52:102-10.
  • 11. Lorenzo A, Razzaboni B, Weir GC, et al. Pancreatic islet cell toxicity of amylin associated with type-2 diabetes mellitus. Nature 1994;368:756-60.
  • 12. Clark A, Cooper GJ, Lewis CE, et al. Islet amyloid formed from diabetes-associated peptide may be pathogenic in type-2 diabetes. Lancet 1987;2:231-4.
  • 13. Eizirik DL, Korbutt GS, Hellerström C. Prolonged exposure of human pancreatic islets to high glucose concentrations in vitro impairs the beta-cell function. J Clin Invest 1992;90:1263-12.
  • 14. Marshak S, Leibowitz G, Bertuzzi F, et al. Impaired beta-cell functions induced by chronic exposure of cultured human pancreatic islets to high glucose. Diabetes 1999;48:1230-6.
  • 15. Maedler K, Spinas GA, Lehmann R, et al. Glucose induces β-cell apoptosis via upregulation of the Fasreceptor in human islets. Diabetes 2001;50:1683-90.
  • 16. Federici M, Hribal M, Perego L, et al. High glucose causes apoptosis in cultured human pancreatic islets of Langerhans: a potential role for regulation of specific Bcl family genes toward an apoptotic cell death program. Diabetes 2001;50:1290-301.
  • 17. Eizirik DL, Cardozo AK, Cnop M. The role for endoplasmic reticulum stress in diabetes mellitus. Endocr Rev 2008;29:42-61.
  • 18. Hotamisligil GS. Endoplasmic reticulum stress and the inflammatory basis of metabolic disease. Cell 2010;140:900-17.
  • 19. Oslowski CM, Hara T, O’Sullivan-Murphy B, et al. Thioredoxin interacting protein mediates ER stress-induced β cell death through initiation of the inflammasome. Cell Metab 2012;16:265-73.
  • 20. American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2018 Diabetes Care 2018;41(Supplement 1):13-27.
  • 21. Jurgens CA, Toukatly MN, Fligner CL, et al. β-Cell loss and β- cell apoptosis in human type 2 diabetes are related to islet amyloid deposition. Am J Pathol 2011;178: 2632-40.
  • 22. El-Assaad W, Buteau J, Peyot ML, et al. Saturated fatty acids synergize with elevated glucose to cause pancreatic β-cell death. Endocrinology 2003;144:4154-63.
  • 23. Inzucchi SE, Bergenstal RM, Buse JB, et al; American Diabetes Association (ADA); European Association for the Study of Diabetes (EASD). Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2012;35:1364-79.
  • 24. Lingvay I, Legendre JL, Kaloyanova PF, et al. Insulinbased versus triple oral therapy for newly diagnosed type 2 diabetes: which is better? Diabetes Care 2009;32:1789-95.
  • 25. Robertson RP, Harmon J, Tran PO, et al. Glucose toxicity in beta-cells: type 2 diabetes, good radicals gone bad, and the glutathione connection. Diabetes 2003;52:581-7.
  • 26. Poitout V, Robertson RP. Glucolipotoxicity: Fuel excess and β-cell dysfunction. Endocr Rev 2008;29:351–66. 27. Kim JW, Yoon KH. Glucolipotoxicity in pancreatic β-Cells. Diabetes Metab J 2011;35:444-50.
  • 28. Poitout V, Olson LK, Robertson RP. Chronic exposure of betaTC- 6 cells to supraphysiologic concentrations of glucose decreases binding of the RIPE3b1 insulin gene transcription activator. J Clin Invest 1996;97:1041-6.
  • 29. van Raalte DH, Diamant M. Glucolipotoxicity and beta cells in type 2 diabetes mellitus: target for durable therapy? Diabetes Res Clin Pract 2011;93Suppl 1:37- 46.
  • 30. Prentki M, Nolan CJ. Islet beta cell failure in type 2 diabetes. J Clin Invest 2006;116:1802-12.
  • 31. Glaser B, Leibovitz G, Nesher R, Hartling S, Binder C, Cerasi E 1988 Improved _-cell function after intensive insulin treatment in severe non-insulin-dependent diabetes. Acta Endocrinol 118:365–73.
  • 32. Weng J, Li Y, Xu W et al. Effect of intensive insulin therapy on beta-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes: A multicentre randomised parallel-group trial. Lancet 2008;371:1753–60.
  • 33. Wang Z, York NW, Nichols CG, Remedi MS. Pancreatic beta cell dedifferentiation in diabetes and redifferentiation following insulin therapy. Cell Metab 2014;19:872–82.
  • 34. Nakayama H, Kato T, Nakayama S, et al. Cross-sectional and Longitudinal Analyses of Factors Contributing to the Progressive Loss of the β-cell Function in Type 2 Diabetes.Intern Med 2015;54:1971-6.
  • 35. Giroix MH, Irminger JC, Lacraz G, et al. Hypercholesterolaemia, signs of islet microangiopathy and altered angiogenesis precede onset of type 2 diabetes in the Goto-Kakizaki (GK) rat. Diabetologia 2011;54:2451-62.
  • 36. Fujiwara D, Takahashi K, Suzuki T, et al. Postprandial serum C-peptide value is the optimal index to identify patients with non-obese type 2 diabetes who require multiple daily insulin injection: Analysis of C peptide values before and after short-term intensive insulin therapy.J Diabetes Investig 2013;4:618-25.
  • 37. Crisman M, Lucchetta L, Luethi N, et al. The effect of insulin administration on c-peptide in critically ill patients with type 2 diabetes.Ann Intensive Care. 2017;7:50.
  • 38. Nathan DM, Singer DE, Hurxthal K, et al. The clinical information value of the glycosylated hemoglobin assay. N Engl J Med 1984;310:341.
  • 39. Jones AG, Hattersley AT. The clinical utility of C-peptide measurement in the care of patients with diabetes. Diabet Med 2013;30:803–17.
  • 40. Chima RS, LaMontagne T, Piraino G, et al. C-peptide, a novel inhibitor of lung inflammation following hemorrhagic shock. Am J Physiol Lung Cell Mol Physiol 2011;300:L730–9.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
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