scholarly journals Study of fasting & PP C- peptide & its correlation with HbA1c in T2 Diabetes mellitus in population of Uttarakhand

2022 ◽  
Vol 8 (4) ◽  
pp. 245-247
Author(s):  
Farah Ahsan ◽  
Naeem Qureshi ◽  
Sumera Samreen ◽  
Sonali Kukreti

We aimed to provide correlation of Fasting & PP C-peptide with HbA1C in patients of T2 Diabetes Mellitus.: 50 patients admitted in IPD of Medicine department in Shri Mahant Indresh Hospital from April-August 2021. Serum samples taken for fasting & PP C-peptide and HbA1C for patients of T2 Diabetes Mellitus and run on VITROS 5600/7600 which is based on dry chemistry. : We took 50 patients who were T2DM then we did fasting C peptide & PP C-peptide and HbA1c. Out of 50, 15 were females &35 were males. Out of 50, 45 patients had raised HbA1C maximum around 8-10.Mean & SD for fasting C-Peptide for males was 1.346±1.070 & for females 2.442±2.57.Mean & SD for Post prandiol C-Peptide for males was 4.208±5.020 & for females 2.993±2.130.It was significant for fasting C- Peptide with P value 0.0371 and non significant for PP C peptide with p value 0.3731.: Insulin secretion estimated by measurement of Fasting C-Peptide was either normal or raised in newly diagnosed T2DM subjects in my study indicating predominant role of insulin resistence in the etiology. Further research can explore the exact contribution of insulin resistence and insulin secretory defects in this area.

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A478-A478
Author(s):  
Vipin Verma ◽  
Mark Cromer ◽  
Blocker Riddick ◽  
Jordan M O’Steen ◽  
Mc Anto Antony ◽  
...  

Abstract Introduction: Gastrin release from G cells stimulates cholecystokinin (CCK2) receptors throughout the body, most of which promote gastric acid secretion. However, gastrin also stimulates CCK2 receptors located elsewhere, including the islet of the pancreas. In turn, gastrin increases insulin secretion1. Gastrin also promotes pancreatic β cell neogenesis and replication. Proton pump inhibitors (PPIs) decrease the pH of the stomach and stimulate gastrin secretion, which may indirectly promote insulin secretion and improve hemoglobin A1c (HbA1c). Objective: To understand the effect of PPIs on insulin-glucose homeostasis (c-peptide, HbA1c, and glucose) in patients with type 2 diabetes mellitus (T2DM). Methodology: We retrospectively reviewed the charts of patients with T2DM at least 18 years of age who received care at AnMed Health facilities from Jan. 1, 2018 through Dec. 31, 2018 to compare HbA1c, C-peptide, and glucose levels in patients with and without active PPI therapy. Slicer-dicer software was used to identify study population with diagnosis of T2DM and labs including both HbA1c and C-peptide. Out of total 215 patients satisfying inclusion criteria, 71 patients were on PPI. Statistical analyses were performed using SPSS version 20.0 (SPSS, Armonk, NY: IBM Corp). All values are presented as means ± SD. A p value of < 0.05 was considered to be significant. Independent T-test and chi-square test were performed to compare parameters in between groups. Results: The PPI and non-PPI groups had no statistical difference regarding age, sex, race and BMI. There was no significant difference in HbA1c levels between PPI and non-PPI groups (8.6% ± 2.1 vs 8.3% ± 2.0, respectively; p value = 0.37). However, we found a significant increase in C-peptide levels (3.1 ng/mL ± 2.4 vs 2.4 ng/mL ± 2.3; p value = 0.037) and decrease in LDL levels (79.6 mg/dL ± 34.0 vs 89.73 mg/dL ± 32.9; p value = 0.046) in the PPI group compared to non-PPI group. In addition, there was a significantly greater prevalence of coronary artery disease in the PPI group (p = 0.01). Conclusion: PPI therapy in patients with T2DM was not associated with improved glycemic control. However, C-peptide levels were significantly higher in patients with T2DM who were on PPI therapy suggesting higher insulin secretion. The lack of difference in HbA1c levels may be a result of aggressive diabetic management by treating clinicians to achieve similar goal HbA1c in both groups. Further research is needed to understand the gastrin pathway as a potential option for improving glycemic control. References: 1. Rehfeld JF. Incretin physiology beyond glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide: cholecystokinin and gastrin peptides. Acta Physiol (Oxf). 2011 Apr;201(4):405–11.


2021 ◽  
pp. 19-21
Author(s):  
Shipra Singh ◽  
Dipti Debbarma ◽  
Harishankar Mishra

Introduction: Diabetes mellitus is the commonest endocrine disorder in population. This clinical syndrome is due to either absolute or relative insulin deciency. Currently number of diabetics worldwide is 422 million. In India the projected increase is from 20 to 62 million, The term diabetes is derived from Greek words Dia meaning “through”, and Bainein meaning “to go”. This disease causes loss of weight as if the body mass is passed through urine. It is a disease known from ancient times. Charaka in his treatise, elaborated this disorder as “Madhumeha” (meaning sweet urine) around 400 BC. Aim & Objective: The level of fasting insulin and serum c-peptide in individual with high BMI /sedentary life style; newly diagnosed cases of hypertension / type2 DM; and old cases of diabetes mellitus. Raised level of serum insulin and c-peptide as a cause of progressive diabetes which can lead to cardiovascular complications and help to prepare patient. Materials And Methods: It is an observational cross sectional study done in the diabetic outpatient clinic of our hospital. 60 diabetic patients were evaluated for fasting plasma glucose level, post prandial glucose level, Glycosalated haemoglobin HbA1c, fasting Insulin and fasting C-peptide level. Results And Analysis: From the above table it was inferred that there is very strong positive correlation of HbA1c with C-PEPTIDE and INSULIN ( r > 0.7 and p value = .000 ). From the table it is inferred that there is a very strong positive correlation of INSULIN with C-PEPTIDE ( r > 0.7 and p value =.000 ). From table it is inferred that C-PEPTIDE has a strong negative correlation with SBPand DBP. (r value > 0.7 and p = .000 ). From table it is inferred that INSULIN has a strong negative correlation with SBPand DBP. ( r value > 0.7 and p =.000). Summary & Conclusion: The level of serum insulin and c-peptide is found to be higher in “newly diagnosed” cases than that of “old diagnosed” cases and this can be explained by the fact that treatment modies the course of disease and slows its progression. With passage of duration, hypertension starts to build up in established cases of diabetes. C-peptide and serum insulin testing should be done in patients with poor blood glucose control to decide treatment modalities and to create awareness about lifestyle modications and education to Prevent progression of prediabetic stage to diabetic and further to its complicated stage.


2013 ◽  
Vol 32 ◽  
pp. S133
Author(s):  
N. Buchmann ◽  
U. Kassner ◽  
K. Norman ◽  
E. Steinhagen-Thiessen ◽  
I. Demuth ◽  
...  

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Menno Vergeer ◽  
Liam R Brunham ◽  
Joris Koetsveld ◽  
Janine K Kruit ◽  
C B Verchere ◽  
...  

Background The ATP Binding Cassette transporter A1 (ABCA1) transports free cholesterol to nascent high-density lipoproteins (HDL) and maintains plasma HDL levels. In mice, ABCA1 is essential in regulating intracellular cholesterol homeostasis and insulin secretion in the β cell. The role of ABCA1 in human glucose metabolism is unclear. Objective and methods To assess the effects of ABCA1 dysfunction on glucose homeostasis in humans , we matched heterozygous carriers of disruptive mutations in ABCA1 and non-carriers for age, gender and BMI and performed oral glucose tolerance tests (OGTT; 9 vs. 8 respectively) and hyperglycemic clamping experiments (6 vs. 6). Results Carriers had lower HDL-C levels than non-carriers (0.58 ± 0.3 vs. 1.46 ± 0.4 mmol/L, p=0.001) but LDL-C did not differ (3.4 ± 1.0 vs. 2.8 ± 0.8 mmol/L, p=0.21). Fasting plasma glucose was not different (5.2 ± 1.5 vs. 5.0 ± 0.4 mmol/L). Glucose curves after OGTT were significantly higher in carriers than in non-carriers (genotype * time interaction, p=0.005; plasma glucose at t=60 min 9.0 ± 3.0 mmol/L vs. 6.0 ± 1.4 mmol/L respectively, p=0.02). During hyperglycemic clamps, carriers showed a lower first phase insulin and C-peptide response than non-carriers (genotype * time interaction, p<0.05 and p<0.01 respectively; insulin at t=5 min 164±118 vs. 352 ±141 pmol/L, p<0.05; C-peptide at t=5 min 1033 ± 628 vs. 1942 ± 723 pmol/L, p<0.05) but no difference in insulin sensitivity index (0.0216 ± 0.012 mg kg −1 . min −1 . pM −1 for carriers and 0.0197 ± 0.005 mg kg −1 . min −1 . pM −1 for non-carriers; p=0.73). Disposition index - a measure of β cell function, adjusted for insulin sensitivity - was lower in carriers than in non-carriers (1037 ± 610 vs. 2718 ± 1524; p<0.05). Non-carriers responded to an arginine stimulus with an increase in C-peptide levels (from 3558 ± 1240 pM to 6817 ± 1665 pM; p<0.005), whereas in carriers this increase did not reach statistical significance (from 3727 ± 1843 pM to 5480 ± 1757 pM; p=0.12). Conclusion Carriers of loss-of-function mutations in ABCA1 show impaired insulin secretion without insulin resistance, resulting in glucose intolerance. Our data confirm previous studies in mice and provide evidence for a role of ABCA1 in β cell dysfunction and the pathophysiology of diabetes mellitus in man.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Simona I. Chisalita ◽  
J. Ludvigsson

Background. Type 1 diabetes (T1D) in adolescents is associated with alterations in the insulin-like factor system probably caused both by a deranged metabolism and insulinopenia in the portal vein. Objective. To study how the circulating IGF-1 is affected at diagnosis and during subsequent years in adolescents with T1D. Methods. Ten girls and ten boys with type 1 diabetes (T1D), aged 13.0 ± 1.4 (mean ± SD) years at diagnosis, took part in the study. Blood samples were drawn at diagnosis and after 3, 9, 18, and 48 months. HbA1c, total IGF-1, and C-peptide were measured. Results. At diagnosis, the patients had high HbA1c, low IGF-1, and measurable C-peptide. After the start of insulin treatment, maximal improvement in glycemic control and IGF-1 occurred within 3 months and then both tended to deteriorate, that is, HbA1c to increase and IGF-1 to decrease. C-peptide decreased with time, and after 4 years, half of the patients were C-peptide negative. At diagnosis, C-peptide correlated positively to IGF-1 (r=0.50; p<0.03). C-peptide correlated negatively with insulin dose (U/kg) after 18 and 48 months from diagnosis (r=−0.48; p<0.03 and r=−0.72; p<0.001, resp.). Conclusions. In conclusion, our results show that in newly diagnosed adolescents with type 1 diabetes and deranged metabolism, the IGF-1 level is low and rapidly improves with insulin treatment but later tends to decrease concomitantly with declining endogenous insulin secretion.


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