Pattern of C-peptide response to oral glucose tolerance test: Interest and cut-off values

Bonnet-Serrano, Fidéline; Jaoude, Mathieu Abou; Laguillier, Christelle; Gobeaux, Camille; Bouzerara, Amina; Mosnier-Pudar, Helen; Gadrey, Jean

doi:10.1016/j.ando.2021.12.006

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…In contrast, in patients with glucose intolerance or type 2 diabetes peak plasma glucose concentrations are delayed up to 120 min. Furthermore, plasma glucose and insulin concentrations are higher than in a healthy population 15,16 . Insulin enters the bioactive state through the decoupling of C-peptide from proinsulin.…”

Section: Discussionmentioning

confidence: 87%

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The substitute ENSO 16 has low impact on glucose metabolism in healthy humans: a randomized, double-blind, active-controlled, cross-over trial

Lutnik,

Weisshaar,

Mussbacher

et al. 2024

Sci Rep

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High sugar consumption is associated with cardiovascular diseases and diabetes. Current sugar substitutes may cause taste sensations and gastrointestinal symptoms. ENSO 16 is a combination of 16 different sugar substitutes and plant fibers and has been designed as a sugar alternative. The impact on plasma glucose metabolism as well as on gastrointestinal tolerance has not been investigated yet. 17 healthy participants were enrolled in this randomized, double-blind trial. Participants received a single oral dose of 30 g glucose or 30 g ENSO 16 and crossed over to the alternate treatment after a 7 day wash out period. The study endpoint was the effect on plasma glucose, insulin, C-peptide concentrations and gastrointestinal disorders. A questionnaire regarding gastrointestinal symptoms was used for individual subjective scoring. The mean baseline adjusted plasma glucose AUC0–180 min was significantly greater after glucose administration compared to ENSO 16 (n = 15, p = 0.0128, paired t-test). Maximum plasma glucose elevation over baseline was 117 mg*dl−1 and 20 mg*dl−1 after oral glucose or ENSO 16, respectively. Insulin and C-peptide AUC0−180 min were significantly greater after glucose compared to ENSO 16 intake (p < 0.01, Wilcoxon rank sum test). The mean maximal concentrations of plasma glucose, insulin and C-peptide after glucose intake were 1.5, 4.6 and 2.7-fold greater after glucose intake compared to ENSO 16 intake, respectively. Adverse reactions were mostly mild and not different between treatments. Conclusion. ENSO 16 has only a small impact on plasma glucose metabolism. This may be of interest in a dietary context and may help to reduce calory intake.Trail registration NCT05457400. First registration: 14/07/2022. https://clinicaltrials.gov/study/NCT05457400.

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Section: Discussionmentioning

confidence: 87%

“…Insulin enters the bioactive state through the decoupling of C-peptide from proinsulin. C-peptide has a longer half-life than insulin 15 . This is consistent with the observed peak of C-peptide after 45 min, which occurred after the insulin peak after glucose intake.…”

Section: Discussionmentioning

confidence: 99%

The substitute ENSO 16 has low impact on glucose metabolism in healthy humans: a randomized, double-blind, active-controlled, cross-over trial

Lutnik,

Weisshaar,

Mussbacher

et al. 2024

Sci Rep

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C-peptide level concomitant with hypoglycemia gives better performances than insulin for the diagnosis of endogenous hyperinsulinism: a single-center study of 159 fasting trials

Bonnet-Serrano

Devin-Genteuil

Thomeret

et al. 2023

European Journal of Endocrinology

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Introduction Diagnosis of endogenous hyperinsulinism relies on the occurrence of a hypoglycemia, concomitant with inadequate high insulin and C-peptide levels. However, diagnostic cut-offs are not consensual among the different learned societies. The objective of this work was to propose optimized cut-offs for these three parameters for the diagnosis of endogenous hyperinsulinism. Methods All the patients having performed a fasting trial in Cochin Hospital Endocrinology Department between February 2012 and August 2022 were included. The results of glycemia, insulin and C-peptide levels during fasting trial were collected and analyzed. Results One hundred and fifty-nine patients were included: 26 with endogenous hyperinsulinism and 133 without endogenous hyperinsulinism. ROC analysis of glycemia nadir during fasting trial identified the value of 2.3 mmol/L as the optimal cut-off, ensuring a sensitivity of 100% associated with a specificity of 81%. ROC analysis of insulin and C-peptide levels concomitant with hypoglycemia < 2.3 mmol/L showed very good diagnostic performances of both parameters with respective cut-offs of 3.1 mUI/L (= 21.5 pmol/L; sensitivity = 96%; specificity = 92%) and 0.30 nmol/L (sensitivity =96%; specificity = 100%). Insulin to glycemia ratio as well as C-peptide to glycemia ratio (in pmol/mmol) at the time of glycemia nadir did not show better diagnostic performances than C-peptide alone. Conclusion A C-peptide level 0.3 nmol/L concomitant with a hypoglycemia < 2.3 mmol/L appears as the best criterion to make the diagnosis of endogenous hyperinsulinism. Insulin level can be underestimated on hemolyzed blood samples, frequently observed in fasting trial, and thus shows lower diagnostic performances.

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Evaluation of beta cell function in newly diagnosed type 2 diabetes mellitus in clinical practice

Stojanović¹,

Zivkovic²

2023

Medicinski podmladak

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Dysfunctions underlining type 2 diabetes mellitus (DM2) evolution are insulin resistance and beta-cell secretory insufficiency. Practical but reliable beta-cell function (BCF) testing is still elusive. Methods of BCF measurement include the homeostasis model assessment (HOMA), glucagon stimulation test (GST), oral glucose tolerance tests (OGTT), intravenous glucose tolerance tests (IVGTT), meal tolerance tests (MTT) and the hyperglycemic clamp procedure. Oral tests have the advantage of simpler use and superior approximation of real-life stimulation inclusive for incretin activation effects. The advantage of the test meal over the OGTT incudes a more adequate simulation of nutrients effect on incretin secretion. Therefore, a standardized test meal (STO) would best reflect the spike in insulin secretion after a meal in real life. Conclusion: Standardized test meal, as potent stimulus of C-peptide secretion, is a promising simple and naturalistic alternative to in vivo assess beta-cell function in an affordable outpatient setting, through analysis of C-peptide response in newly diagnosed diabetic patients, as potent stimulus of C-peptide secretion.

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Pattern of C-peptide response to oral glucose tolerance test: Interest and cut-off values

Cited by 3 publications

References 17 publications

The substitute ENSO 16 has low impact on glucose metabolism in healthy humans: a randomized, double-blind, active-controlled, cross-over trial

The substitute ENSO 16 has low impact on glucose metabolism in healthy humans: a randomized, double-blind, active-controlled, cross-over trial

C-peptide level concomitant with hypoglycemia gives better performances than insulin for the diagnosis of endogenous hyperinsulinism: a single-center study of 159 fasting trials

Evaluation of beta cell function in newly diagnosed type 2 diabetes mellitus in clinical practice

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