C-peptide Response to Glucagon: A Test for the Residual β-cell Function in Diabetes Mellitus

Faber, O. K.; Binder, Chr.

doi:10.2337/diab.26.7.605

Cited by 331 publications

(137 citation statements)

References 4 publications

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“…It has been suggested that the fasting C-peptide concentration is not only a qualitative, but also a quantitative measure of the insulin secretion [8]. This suggestion is supported by the present study, as the fasting C-peptide concentration correlated well with the increase following stimulation.…”

Section: Discussionsupporting

confidence: 89%

“…It has previously been shown that the increase in plasma C-peptide concentration in response to 1 mg of IV glucagon is a quantitative measure of the functional B-cell secretory capacity under physiological conditions in patients with insulin-dependent diabetes of short duration [8]. The good correlation found in the present study between the C-peptide response to I mg of IV glucagon and to a standard meal suggests that the glucagon test, as a measure of residual B-cell function, is applicable also to insulintreated diabetics with a diabetes duration of up to 50 years.…”

Section: Discussionmentioning

confidence: 99%

“…Determination of the C-peptide concentration before and after stimulation with glucagon has been found to reflect quantitatively B-ceU function under normal conditions of life in patients with insulin-dependent diabetes mellitus of short duration [8].…”

mentioning

confidence: 99%

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Prevalence of residual B-cell function in insulin-treated diabetics evaluated by the plasma C-peptide response to intravenous glucagon

Hendriksen¹,

Faber²,

Drejer³

et al. 1977

Diabetologia

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Summary. In 83 insulin-treated diabetics the influence of the duration of insulin treatment on the prevalence of residual insulin secretion was examined by determining the plasma C-peptide concentration before and after intravenous injection of 1 mg of glucagon. In 64 patients, plasma C-peptide concentration was also determined before and after a standard meal. There was a good correlation between the C-peptide response to glucagon and to the meal (r = 0.67; p < 0.0001) suggesting that the glucagon test will predict the B-cell response during everyday life. The predictive value of a positive glucagon test was 84% and of a negative test 100%. A preserved, but reduced, B-cell function was demonstrable in 36 of 83 patients. Residual B-cell function was most frequent in the patients with the shortest duration of diabetes. The metabolic importance of endogenous insulin was demonstrated by the significantly lower insulin requirement in the patients with residual B-cell function.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of residual B-cell function in insulin-treated diabetics evaluated by the plasma C-peptide response to intravenous glucagon

Hendriksen¹,

Faber²,

Drejer³

et al. 1977

Diabetologia

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“…Insulin-treated lean patients (body mass index < 25 kg/m in females, body mass index < 27 kg/r2 in males) had a glucagon test performed, and Type 2 diabetes was diagnosed if a stimulated C-peptide value was equal to or above 0.60 pmol/ml [11]. Fasting blood samples for plasma C-peptide determination were obtained before and 6 min after an intravenous bolus injection of 1 mg glucagon (Novo, Bagsvaerd, Denmark) as described previously [12].…”

Section: Subjectsmentioning

confidence: 99%

Glomerular size-and charge selectivity in Type 2 (non-insulin-dependent) diabetic patients with diabetic nephropathy

et al. 1994

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“…The C-peptide response to glucagon was introduced for more than a decade ago as a measure of pancreatic responsiveness in Type i diabetes mellitus [3]. The test has now become widely used in patients with Type 1 diabetes [4][5][6][7][8][9] but also in patients with Type 2 diabetes mellitus [8][9][10][11].…”

mentioning

confidence: 99%

Fasting plasma C-peptide, glucagon stimulated plasma C-peptide, and urinary C-peptide in relation to clinical type of diabetes

Gjessing¹,

Matzen²,

Faber³

et al. 1989

Diabetologia

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Summary. Many patients with Type 2 (non-insulin-dependent) diabetes mellitus are treated with insulin in order to control hyperglycaemia. We studied fasting plasma C-peptide, glucagon stimulated plasma C-peptide, and 24 h urinary Cpeptide in relation to clinical type of diabetes in 132 insulin treated diabetic subjects. Patients were classified clinically as Type 1 (insulin-dependent) diabetic subjects in the presence of at least two of the following criteria: 1) significant ketonuria, 2)insulin treatment started within one year after diagnosis, 3) age of diagnosis < 40 years, and 4) weight below 110% of ideal weight of the same age and sex. Eighty patients were classified as Type 1 and 52 as Type 2 diabetic subjects. A second classification of patients into 6 C-peptide classes was then performed. Class I consisted of patients without islet Bcell function. Class II-VI had preserved islet B-cell function and were separated according to the 20%, 40%, 60% and 80% C-peptide percentiles. The two classifications of patients were compared by calculating the prevalence of clinical Type I and Type 2 diabetes in each of the C-peptide classes. This analysis showed that patients with a fasting plasma C-peptide value < 0.20 nmol/1, a glucagon stimulated plasma C-peptide value < 0.32 nmol/1, and a urinary C-peptide value < 3.1 nmol/1, or < 0.54 nmol/mmol creatinine/24 h, or < 5.4 nmol/24 h mainly were Type I diabetic patients; while patients with Cpeptide levels above these values mainly were Type 2. At these limits the percentage, predictive value of positive tests as indicators of Type 2 diabetes were as follows: fasting C-peptide 83%, stimulated C-peptide 86%, and urinary C-peptide expressed as nmol/1 76%, as nmol/mmol creatinine/24 h 79%, and as nmol/24 h 78%. Similarly, the percentage predictive value of negative tests as indicators of Type 1 diabetes were as follows: fasting C-peptide 86%, stimulated C-peptide 88%, and urinary C-peptide expressed as nmol/1 79%, as nmol. mmol creatinine-24 h 81%, and as nmol/24 h 80%. If patients without detectable C-peptide were excluded, the predictive value of negative tests were as follows: fasting C-peptide 81%, stimulated C-peptide 88%, urinary C-peptide expressed as nmol/161%, as nmol/mmol creatinine/24h 69%, and as nmol/24 h 64%. In conclusion, post glucagon C-peptide gives a good distinction between Type 1 and Type 2 diabetes mellitus in insulin treated diabetes while 24 h urinary C-peptide gives a less sensitive distinction between the clinical types of diabetes.

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C-peptide Response to Glucagon: A Test for the Residual β-cell Function in Diabetes Mellitus

Cited by 331 publications

References 4 publications

Prevalence of residual B-cell function in insulin-treated diabetics evaluated by the plasma C-peptide response to intravenous glucagon

Prevalence of residual B-cell function in insulin-treated diabetics evaluated by the plasma C-peptide response to intravenous glucagon

Glomerular size-and charge selectivity in Type 2 (non-insulin-dependent) diabetic patients with diabetic nephropathy

Fasting plasma C-peptide, glucagon stimulated plasma C-peptide, and urinary C-peptide in relation to clinical type of diabetes

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