Lower Hypoglycemia Risk in Type 1 Diabetes Seen With Higher C-Peptide Levels

For a long time, conventional wisdom held that people with type 1 diabetes produce no insulin in their pancreas once the disease is established — or that if some insulin still gets produced, the amount would be too small to be relevant.

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Scientists now know that in some people with type 1 diabetes, the pancreas still does produce some insulin. That’s because along with insulin, the organ produces a protein called C-peptide. It’s very difficult to consistently measure how much insulin your pancreas produces, especially if you take insulin to treat your diabetes. C-peptide remains in your blood for longer than insulin does, and it isn’t affected by insulin that you inject — so it’s a great way to estimate how much insulin your pancreas is producing.

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But even if some people with type 1 diabetes still produce some insulin on their own, does this make any meaningful difference in your health? A recent study suggests that it can, by lowering the risk of hypoglycemia (low blood glucose).

Published in the journal Diabetic Medicine, the study looked at 221 adults who had had type 1 diabetes for at least 5 years. C-peptide levels were measured after a standardized meal, and data was collected on insulin doses, self-reported episodes of hypoglycemia, and microvascular diabetes complications.

The researchers divided participants into two groups based on a C-peptide level cutoff of 20 pmol/l after the meal. In the preserved C-peptide group, the median level was 114 pmol/l, while in the low C-peptide group, it was less than 3 pmol/l.

Participants with preserved C-peptide were found to have reported 21% fewer symptomatic episodes of hypoglycemia than those with low C-peptide, along with 65% fewer asymptomatic episodes (based just on blood glucose measurements). Those with preserved C-peptide also took 16% less insulin as a proportion of their body weight. There was no significant difference in HbA1c levels (a measure of long-term blood glucose control) between the two groups.

This study suggests that if treatments were developed to help people with newly diagnosed type 1 diabetes retain some insulin production, they could benefit by having a lower risk for hypoglycemia and using less insulin over time.

Want to learn more about recent type 1 diabetes research? Read “Kidney Disease Risk in Type 1 Diabetes Tied to Blood Pressure, Glucose Levels,” “Type 1 Diabetes at Early Age May Affect Brain Growth: Study”  and “Quarter of People in U.S. With Type 1 Diabetes Ration Insulin.”

Quinn PhillipsQuinn Phillips

A freelance health writer and editor based in Wisconsin, Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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