Tuccinardi Dario1, Giorgino Riccardo1,2, Pieralice Silvia1, Watanabe Mikiko3, Maggi Daria1, Palermo Andrea1, Defeudis Giuseppe1, Fioriti Elvira1, Pozzilli Paolo4,5, Manfrini Silvia1. 1. Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy. 2. Orthopedics and Traumatology, University of Milan, Milan, Italy. 3. Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy. 4. Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy. p.pozzilli@unicampus.it. 5. Centre of Immunobiology, Barts and London School of Medicine and Dentistry, Queen Mary University of London, London, UK. p.pozzilli@unicampus.it.
Abstract
AIMS: We aimed at evaluating residual β-cell function in insulin-treated patients with type 2 diabetes (T2D) while determining for the first time the difference in C-peptide level between patients on basal-bolus compared to those on the basal insulin scheme, considered as an early stage of insulin treatment, together with assessing its correlation with the presence of complications. METHODS: A total of 93 candidates with T2D were enrolled in this cross-sectional study and were categorized into two groups based on the insulin regimen: Basal-Bolus (BB) if on both basal and rapid acting insulin, and Basal (B) if on basal insulin only, without rapid acting injections. HbA1c, fasting C-peptide concentration and other metabolic parameters were recorded, as well as the patient medical history. RESULTS: The average fasting C-peptide was 1.81 ± 0.15 ng/mL, and its levels showed a significant inverse correlation with the duration of diabetes (r = -0.24, p = 0.03). Despite similar disease duration and metabolic control, BB participants displayed lower fasting C-peptide (p < 0.005) and higher fasting glucose (P = 0.01) compared with B patients. Concentrations below 1.09 ng/mL could predict the adoption of a basal-bolus treatment (Area 0.64, 95%CI:0.521-0.759, p = 0.038, sensitivity 45% and specificity 81%). CONCLUSIONS: Insulin-treated patients with long-standing T2D showed detectable level of fasting C-peptide. Measuring the β-cell function may therefore guide toward effective therapeutic options when oral hypoglycemic agents prove unsuccessful.
AIMS: We aimed at evaluating residual β-cell function in insulin-treated patients with type 2 diabetes (T2D) while determining for the first time the difference in C-peptide level between patients on basal-bolus compared to those on the basal insulin scheme, considered as an early stage of insulin treatment, together with assessing its correlation with the presence of complications. METHODS: A total of 93 candidates with T2D were enrolled in this cross-sectional study and were categorized into two groups based on the insulin regimen: Basal-Bolus (BB) if on both basal and rapid acting insulin, and Basal (B) if on basal insulin only, without rapid acting injections. HbA1c, fasting C-peptide concentration and other metabolic parameters were recorded, as well as the patient medical history. RESULTS: The average fasting C-peptide was 1.81 ± 0.15 ng/mL, and its levels showed a significant inverse correlation with the duration of diabetes (r = -0.24, p = 0.03). Despite similar disease duration and metabolic control, BB participants displayed lower fasting C-peptide (p < 0.005) and higher fasting glucose (P = 0.01) compared with B patients. Concentrations below 1.09 ng/mL could predict the adoption of a basal-bolus treatment (Area 0.64, 95%CI:0.521-0.759, p = 0.038, sensitivity 45% and specificity 81%). CONCLUSIONS:Insulin-treated patients with long-standing T2D showed detectable level of fasting C-peptide. Measuring the β-cell function may therefore guide toward effective therapeutic options when oral hypoglycemic agents prove unsuccessful.
Entities:
Keywords:
Beta cell; C-peptide; Insulin treatment; Type 2 diabetes
Authors: A Soare; R Del Toro; Y M Khazrai; A Di Mauro; S Fallucca; S Angeletti; E Skrami; R Gesuita; D Tuccinardi; S Manfrini; F Fallucca; M Pianesi; P Pozzilli Journal: Nutr Diabetes Date: 2016-08-15 Impact factor: 5.097
Authors: Ernesto Maddaloni; Geremia B Bolli; Brian M Frier; Randie R Little; Richard D Leslie; Paolo Pozzilli; Raffaela Buzzetti Journal: Diabetes Obes Metab Date: 2022-06-28 Impact factor: 6.408