Fasting serum C-peptide is useful for initial classification of diabetes mellitus in children and adolescents.
10.6065/apem.2014.19.2.80
- Author:
Min Jung CHO
1
;
Min Sun KIM
;
Chan Jong KIM
;
Eun Young KIM
;
Jong Duk KIM
;
Eun Young KIM
;
Dae Yeol LEE
Author Information
1. Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea. children@jbnu.ac.kr
- Publication Type:Original Article
- Keywords:
C-peptide;
Classification;
Diabetes mellitus;
Child
- MeSH:
Adolescent*;
Autoantibodies;
C-Peptide*;
Child*;
Classification*;
Diabetes Mellitus*;
Diabetes Mellitus, Type 2;
Diagnosis;
Fasting*;
Humans;
Leukocytes;
Obesity
- From:Annals of Pediatric Endocrinology & Metabolism
2014;19(2):80-85
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: With rising obesity rates in children, it is increasingly difficult to differentiate between type 1 and type 2 diabetes mellitus (T1DM, T2DM) on clinical grounds alone. Using C-peptide as a method of classifying diabetes mellitus (DM) has been suggested. This study aimed to find a correlation between fasting C-peptide level and DM types in children and adolescents. METHODS: A total of 223 diabetic children, newly diagnosed at 5 hospitals between January 2001 and December 2012, were enrolled in this study. Initial DM classification was based on clinical and laboratory data including fasting C-peptide at diagnosis; final classification was based on additional data (pancreatic autoantibodies, human leukocyte antigen type, and clinical course). RESULTS: Of 223 diabetic children, 140 were diagnosed with T1DM (62.8%) and the remaining 83 with T2DM (37.2%). The mean serum C-peptide level was significantly lower in children with T1DM (0.80 ng/mL) than in children with T2DM (3.91 ng/mL). Among 223 children, 54 had a serum C-peptide level <0.6 ng/mL; they were all diagnosed with T1DM. The proportion of children with T2DM increased in accordance with C-peptide level. Forty-nine of 223 children had a C-peptide level >3.0 ng/mL; 48 of them (97.9%) were diagnosed with T2DM. CONCLUSION: In this study, we found that if the C-peptide level was <0.6 ng/mL at diagnosis, T2DM could be excluded; if C-peptide level was >3.0 ng/mL, a T1DM diagnosis is unlikely. This finding suggests that serum fasting C-peptide level is useful for classifying DM type at the time of diagnosis in youth.
