Urine C-Peptide Creatinine Ratio Is a Noninvasive Alternative to the Mixed-Meal Tolerance Test in Children and Adults With Type 1 Diabetes

OBJECTIVE-Stimulated serum C-peptide (sCP) during a mixed-meal tolerance test (MMTT) is the gold standard measure of endogenous insulin secretion, but practical issues limit its use. We assessed urine C-peptide creatinine ratio (UCPCR) as an alternative. RESEARCH DESIGN AND METHODS-Seventy-two type 1 diabetic patients (age of diagnosis median 14 years [interquartile range 10-22]; diabetes duration 6.5[2.3-32.7]) had an MMTT. sCP was collected at 90 min. Urine for UCPCR was collected at 120 min and following a home evening meal. RESULTS-MMTT 120-min UCPCR was highly correlated to 90-min sCP (r = 0.97; P andlt; 0.0001). UCPCR andgt;= 0.53 nmol/mmol had 94% sensitivity/100% specificity for significant endogenous insulin secretion (90-min sCP andgt;= 0.2 nmol/L). The 120-min postprandial evening meal UCPCR was highly correlated to 90-min sCP (r = 0.91; P andlt; 0.0001). UCPCR andgt;= 0.37 nmol/mmol had 84% sensitivity/97% specificity for sCP andgt;= 0.2 nmol/L. CONCLUSIONS-UCPCR testing is a sensitive and specific method for detecting insulin secretion. UCPCR may be a practical alternative to serum C-peptide testing, avoiding the need for inpatient investigation.

Ludvigsson, JohnnyÖstergötlands Läns Landsting,Linköpings universitet,Pediatrik,Hälsouniversitetet,Barn- och ungdomskliniken i Linköping(Swepub:liu)johlu29 (författare)
Jones, Angus GUniversity of Exeter (författare)
McDonald, Timothy JUniversity of Exeter (författare)
Shields, Beverley MUniversity of Exeter (författare)
Knight, Bridget AUniversity of Exeter (författare)
Hattersley, Andrew TUniversity of Exeter (författare)
University of ExeterPediatrik (creator_code:org_t)

Ingår i:DIABETES CARE: American Diabetes Association Inc34:3, s. 607-6090149-59921935-5548

Av författaren/redakt...: Besser, Rachel E ...; Ludvigsson, John ...; Jones, Angus G; McDonald, Timoth ...; Shields, Beverle ...; Knight, Bridget ...; visa fler...; Hattersley, Andr ...; visa färre...

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