C-Peptide Index may Predict endogenous insulin secretory capacity under non-fasting conditions: Study

Type 2 diabetes is a chronic metabolic disorder characterized by insulin resistance and pancreatic beta-cell dysfunction. Managing the condition often involves insulin therapy; however, the ability to withdraw from insulin therapy can improve the quality of life for patients. Identifying reliable indicators for withdrawal can guide treatment plans and optimize patient outcomes.

The study was a single-center retrospective analysis involving 147 patients with type 2 diabetes admitted to a hospital. Participants were divided into a withdrawal group (n = 72) and a non-withdrawal group (n = 75) based on whether they were able to withdraw from insulin therapy at discharge. Researchers evaluated the correlation between CPI at 2 hours post-meal and diabetes-related parameters. Machine learning was employed to create clinical models to predict the possibility of withdrawal from insulin therapy.

The key findings of the study were:

• The CPI at 2 hours post-meal was significantly higher in the withdrawal group (2.97 ± 2.07) compared to the non-withdrawal group (1.93 ± 1.28) with a p-value of <0.001.

• This suggests that a higher post-meal CPI is associated with a greater likelihood of withdrawing from insulin therapy.

• CPI at 2 hours post-meal was an independent predictor of withdrawal from insulin therapy.

• It was also found to be a better predictor than fasting CPI.

• Six factors associated with insulin therapy withdrawal (age, duration of diabetes, creatinine, alanine aminotransferase, insulin therapy until hospitalization, and CPI at 2 hours post-meal) were used to create two clinical models using machine learning.

• The accuracy of the generated clinical models ranged from 78.3% to 82.6%.

The study concludes that the CPI at 2 hours post-meal is a clinically useful measure of endogenous insulin secretory capacity under non-fasting conditions. This measure can serve as a valuable tool for predicting the possibility of withdrawal from insulin therapy in patients with type 2 diabetes. This finding can help tailor treatment plans to individual patients' needs, potentially improving their overall quality of life.

Reference:

Iwamoto, Y., Kimura, T., Shimoda, M., Morimoto, Y., Watanabe, Y., Itoh, T., Sasaki, T., Mori, S., Kubo, M., Takenouchi, H., Dan, K., Iwamoto, H., Sanada, J., Fushimi, Y., Katakura, Y., Nakanishi, S., Mune, T., Kaku, K., & Kaneto, H. (2024). C‐peptide index at 2 h post‐meal is a useful predictor of endogenous insulin secretory capacity and withdrawal from insulin therapy in subjects with type 2 diabetes. Diabetes, Obesity & Metabolism. https://doi.org/10.1111/dom.15595