Impact of C-Peptide Preservation on Metabolic and Clinical Outcomes in the Diabetes Control and Complications Trial
Clinical Trial News Tuesday, October 8th, 2013Diabetes: October 2, 2013
The DCCT established that a stimulated C-peptide concentration ≥0.2 nmol/L at study entry among subjects with up to 5 years diabetes duration is associated with favorable metabolic and clinical outcomes over the subsequent 7 years of follow-up. Herein we further examine the association of both fasting and stimulated C-peptide numerical values with outcomes. In the intensive treatment group, for a 50% higher stimulated C-peptide on entry, such as from 0.10 to 0.15 nmol/L, HbA1c decreased by 0.07 HbA1c% (0.8 mmol/mol, p=0.0003); insulin dose decreased by 0.0276 U/kg/d (p<0.0001); hypoglycemia risk was decreased by 8.2% (p<0.0001); and the risk of sustained retinopathy was reduced by 25% (p=0.0010), all in unadjusted analyses. Other than HbA1c, these effects remained significant after adjusting for the HbA1c on entry. While C-peptide was not significantly associated with the incidence of nephropathy, it was strongly associated with the albumin excretion rate. The fasting C-peptide had weaker associations with outcomes. Read More
