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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 
 Journal of Diabetes Investigation, Vol.5(5) : 517-524, 2014 
Journal Title
 Journal of Diabetes Investigation 
Issue Date
C‐peptide ; Pancreatic β‐cell ; Type 2 diabetes mellitus
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Lee, Hyun Chul(이현철)
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
Hwang, Se Na(황세나)
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