EP816 - ECE_2033 - The clinical value of routine C-peptide measurement in diabetes diagnosis and management: a two-case series
Abstract
Case 1
Accurate classification of diabetes type at diagnosis is crucial for appropriate management. Clinical presentation alone may be misleading, particularly in young patients with weight loss and ketosis. C-peptide measurement can provide valuable information regarding endogenous insulin secretion and guide therapeutic decisions.
A 33-year-old man with no prior chronic illnesses presented with unintentional weight loss of 10 kg over two weeks, polydipsia, and polyuria. His body mass index was 19.5 kg/m2. Laboratory evaluation revealed fasting plasma glucose of 309 mg/dL, HbA1c of 11.6%, and urinary ketones of 5 mmol/L. Given the clinical picture suggestive of type 1 diabetes, further evaluation was performed to determine diabetes type.
Fasting C-peptide level was 2.49 ng/mL (reference range 0.73-4.37), indicating preserved endogenous insulin secretion. Based on this finding, insulin therapy was deferred, and treatment with oral hypoglycemic agents (DPP-4 inhibitor combined with metformin), along with dietary modification and increased physical activity, was initiated.
At a 2-week follow-up visit, the patient demonstrated significant improvement in glycemic control, with fasting glucose ranging from 90-125 mg/dL and 2-hour postprandial glucose between 145-185 mg/dL. Weight loss had stabilized, and the patient reported complete resolution of symptoms.
This case highlights the importance of C-peptide measurement in the initial evaluation of patients with newly diagnosed…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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