| Title |
Random non-fasting C-peptide testing can identify patients with insulin-treated type 2 diabetes at high risk of hypoglycaemia
|
|---|---|
| Published in |
Diabetologia, October 2017
|
| DOI | 10.1007/s00125-017-4449-2 |
| Pubmed ID | |
| Authors |
Suzy V. Hope, Bridget A. Knight, Beverley M. Shields, Anita V. Hill, Pratik Choudhary, W. David Strain, Timothy J. McDonald, Angus G. Jones |
| Abstract |
The aim of this study was to determine whether random non-fasting C-peptide (rCP) measurement can be used to assess hypoglycaemia risk in insulin-treated type 2 diabetes. We compared continuous glucose monitoring-assessed SD of blood glucose and hypoglycaemia duration in 17 patients with insulin-treated type 2 diabetes and severe insulin deficiency (rCP < 200 pmol/l) and 17 matched insulin-treated control patients with type 2 diabetes but who had preserved endogenous insulin (rCP > 600 pmol/l). We then assessed the relationship between rCP and questionnaire-based measures of hypoglycaemia in 256 patients with insulin-treated type 2 diabetes and a comparison group of 209 individuals with type 1 diabetes. Continuous glucose monitoring (CGM)-assessed glucose variability and hypoglycaemia was greater in individuals with rCP < 200 pmol/l despite similar mean glucose. In those with low vs high C-peptide, SD of glucose was 4.2 (95% CI 3.7, 4.6) vs 3.0 (2.6, 3.4) mmol/l (p < 0.001). In the low-C-peptide vs high-C-peptide group, the proportion of individuals experiencing sustained hypoglycaemia ≤ 4 mmol/l was 94% vs 41% (p < 0.001), the mean rate of hypoglycaemia was 5.5 (4.4, 6.7) vs 2.1 (1.4, 2.9) episodes per person per week (p = 0.004) and the mean duration was 630 (619, 643) vs 223 (216, 230) min per person per week (p = 0.01). Hypoglycaemia ≤ 3 mmol/l was infrequent in individuals with preserved C-peptide (1.8 [1.2, 2.6] episodes per person per week vs 0.4 [0.1, 0.8] episodes per person per week for low vs high C-peptide, p = 0.04) and only occurred at night. In a population-based cohort with insulin-treated type 2 diabetes, self-reported hypoglycaemia was twice as frequent in those with rCP < 200 pmol/l (OR 2.0, p < 0.001) and the rate of episodes resulting in loss of consciousness or seizure was five times higher (OR 5.0, p = 0.001). The relationship between self-reported hypoglycaemia and C-peptide was similar in individuals with type 1 and type 2 diabetes. Low rCP is associated with increased glucose variability and hypoglycaemia in patients with insulin-treated type 2 diabetes and represents a practical, stable and inexpensive biomarker for assessment of hypoglycaemia risk. |
X Demographics
The data shown below were collected from the profiles of 69 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 26 | 38% |
| France | 4 | 6% |
| Canada | 3 | 4% |
| United States | 2 | 3% |
| India | 2 | 3% |
| Spain | 2 | 3% |
| Italy | 1 | 1% |
| Japan | 1 | 1% |
| Belgium | 1 | 1% |
| Other | 4 | 6% |
| Unknown | 23 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 42 | 61% |
| Practitioners (doctors, other healthcare professionals) | 15 | 22% |
| Scientists | 11 | 16% |
| Science communicators (journalists, bloggers, editors) | 1 | 1% |
Mendeley readers
The data shown below were compiled from readership statistics for 65 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 65 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 14 | 22% |
| Student > Ph. D. Student | 8 | 12% |
| Other | 6 | 9% |
| Student > Master | 6 | 9% |
| Lecturer | 2 | 3% |
| Other | 8 | 12% |
| Unknown | 21 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 20 | 31% |
| Biochemistry, Genetics and Molecular Biology | 5 | 8% |
| Nursing and Health Professions | 4 | 6% |
| Immunology and Microbiology | 2 | 3% |
| Agricultural and Biological Sciences | 2 | 3% |
| Other | 11 | 17% |
| Unknown | 21 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 50. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 September 2022.
All research outputs
#813,215
of 24,787,209 outputs
Outputs from Diabetologia
#432
of 5,300 outputs
Outputs of similar age
#17,226
of 328,100 outputs
Outputs of similar age from Diabetologia
#20
of 95 outputs
Altmetric has tracked 24,787,209 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
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