Postprandial C-peptide to glucose ratio as a predictor of β-cell function and its usefulness for staged management of type 2 diabetes

Eun Young Lee, Sena Hwang, Seo Hee Lee, Yong Ho Lee, A. Ra Choi, Youngki Lee, Byung Wan Lee, Eun Seok Kang, Chul Woo Ahn, Bong Soo Cha, Hyun Chul Lee

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16 Citations (Scopus)

Abstract

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 Korean 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.

Original languageEnglish
Pages (from-to)517-524
Number of pages8
JournalJournal of Diabetes Investigation
Volume5
Issue number5
DOIs
Publication statusPublished - 2014

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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    Lee, E. Y., Hwang, S., Lee, S. H., Lee, Y. H., Choi, A. R., Lee, Y., Lee, B. W., Kang, E. S., Ahn, C. W., Cha, B. S., & Lee, H. C. (2014). Postprandial C-peptide to glucose ratio as a predictor of β-cell function and its usefulness for staged management of type 2 diabetes. Journal of Diabetes Investigation, 5(5), 517-524. https://doi.org/10.1111/jdi.12187