Flash monitoring confirms safety cushion of preserved C-peptide
medwireNews: Even minimal residual C-peptide secretion protects people with type 1 diabetes from hypoglycemic events, and reduces glycemic variability, show data from flash glucose monitoring.
Among 290 people using flash glucose monitoring, those who retained some C-peptide excretion (10–200 pmol/L, measured within the preceding 2 years) had significantly fewer hypoglycemic events (<3.9 mmol/L, 70 mg/dL) per 2 weeks than those with no C-peptide, at a median of seven versus 10.
But people benefitted from even minimal residual C-peptide (10–50 pmol/L), with this group having a median eight hypoglycemic events per 2 weeks, which was also significantly less than in the group without residual C-peptide. The same was true for the proportion of time spent in hypoglycemia, at 3%, 4%, and 5% for people with residual, minimal residual, and no C-peptide, respectively.
The two groups with residual C-peptide also had significantly lower glycemic variability than the group without when measured as either the standard deviation or the coefficient of variability. All associations were independent of diabetes duration and glycated hemoglobin level.
The findings highlight the importance of C-peptide assays with a lower limit of detection below 50 pmol/L, note Fraser Gibb (University of Edinburgh, UK) and colleagues in Diabetologia.
And they add that they “also raise the possibility of stratified glycaemic targets which acknowledge the influence of residual C-peptide secretion.”
medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature group