Residual C‐Peptide Production in Type I Diabetes Mellitus: A Comparison of Different Methods of Assessment and Influence on Glucose Control

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Abstract
The aims of the present study were to compare various methods for assessment of residual insulin production and to evaluate its role in the metabolic regulation in insulin‐dependent, type I diabetes mellitus. Glycosylated hemoglobin (HbA1) was used as a measure of the long‐term glycemic control. Twenty‐eight patients with type I diabetes mellitus with onset before the age of 30 and with a duration of less than 6 years were studied. C‐peptide in plasma in the fasting state, after glucagon stimulation, and the 24‐hour urinary excretion were measured. Fasting plasma C‐peptide was detected in 61%, and 39% showed a significant rise after glucagon stimulation. The increment correlated negatively with HbA1 (rs=‐0.57, prs=‐0.61, pa of 8.9+0.3 %, as opposed to 11.6+0.5% for those excreting less (p<0.001). Measurement of the 24‐hour urinary excretion of C‐peptide provides a reliable method for evaluating residual insulin secretion.