Long-term Effect of C-Peptide Level on Clinical Outcomes in the Scottish Type 1 Bioresource Cohort

What is it about?

What is it about? Type 1 diabetes is a progressive autoimmune disease that affects blood sugar control. As type 1 diabetes progresses, the immune system attacks the cells in the pancreas that produce insulin, and as a result, the ability to secrete insulin and then control blood sugar levels is compromised. However, a proportion of insulin-producing cells can survive, and as a result, many people with type 1 diabetes keep the ability to release small amounts of insulin for years after diagnosis. The easiest way to detect if some insulin production is happening is to measure C-peptide in blood. C-peptide is a protein by-product of insulin that is released at the same time and in similar amounts. Why is it important? Studies have shown that residual C-peptide levels in people with type 1 diabetes are associated with lower risk for some of the important complications of diabetes including very low blood sugar (hypoglycemia) and eye disease (retinopathy). It is important to understand the relationship between the amount of residual C-peptide and risks for health complications that commonly arise in people with type 1 diabetes, both in the short- and long-term. First, understanding what levels of C-peptide might be associated with either risks or benefits could be helpful for healthcare providers in treating people with type 1 diabetes. Second, clear relationships between higher C-peptide levels and better health outcomes provide support for the development and use of treatments that can preserve C-peptide levels in people with type 1 diabetes. This study used a large database of people with type 1 diabetes called the Scottish Diabetes Research Network Type 1 Bioresource (SDRNT1BIO) to study the mathematical relationships between C-peptide levels and health outcomes over a long period of time (~11 years). The results showed that people with lower C-peptide levels at the time of enrollment into the study were at higher risk for serious health complications of extremely low blood sugar (hypoglycemia), hospital admissions for crises with high blood sugar (diabetic ketoacidosis) and eye disease (retinopathy). There were also similar findings made based on C-peptide levels that were measured during the follow-up time. Overall, this study of the SDRNT1BIO cohort provides information about the relationships between C-peptide levels and important health complications and supports the use of C-peptide measurements in the clinic and in type 1 diabetes research.

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