General biochemistry Lecture 1 C peptide and diabetes

Diabetes mellitus • A group of metabolic disorders that requires continuing medical care and patient-self management education to prevent acute complications and to reduce the risk of long term complications. • It is characterized by hyperglycemia and abnormal protein, fat and carbohydrate metabolism due to defects in insulin secretion, i. e. , inadequate and deficient insulin action on target tissues.

It is classified into 4 clinical classes: • Type I diabetes mellitus (TIDM) • Type 2 diabetes mellitus (TIIDM) • Gestational diabetes mellitus (GDM) • Other specific types due to other causes e. g. Drugs or chemical induced.

Diabetic Profile Tests: Group of tests that are used to diagnose diabetes and to measure the treatment. response These Tests include: Ø C-peptide, Differentiates between type I and type II. Ø Blood Glucose Fasting blood glucose (FBG) It also called Fasting Blood Sugar (FBS) = PG=FPG) Post prandial glucose (PP) GGT= Glucose tolerance test, OGGT= Oral glucose tolerance test Ø Hb. A 1 c = Glycosylated hemoglobin. Ø Ketones. Ø Microalbuminurea. Ø Insulin. Ø ICA = islet cell antibodies.

The interpretation of c peptide 1 - Newly diagnosed diabetic patient - Zero or very low c pep. T 1 DM - little pit low or normal T 2 DM - High c pep. With high BG insulin resistance 2 -Diabetic patient treated with B cell or insulin stimulant -Low or normal c pep. With high BG dose not effective should increased. 3 - Diabetic patient treated with insulin -low c pep. With high BG low B cell activity and inaccurate dose or the patient not continue to take the dose.

4 - Food not related hypoglycemia -Very high c pep with low BG insulinoma It used as diagnostic tool and monitoring therapy 5 - Food related hypoglycemia In fasting c pep normal After eating c pep. High it is due to postprandial or reactive hypoglycemia as occur insulin overshot treated with increase numbers of meals and decreasing its quantity with sports 6 - Urine C-Peptide Creatinine Ratio UCPCR TEST. We can evaluate the B cell or insulin activity by using urine samples with the correlation with creatinine 7 - C pep. measuring Not accurate in renal failure patients so not try to measure. C pep excreted through kidney and in this case the kidney not working well so the level of c pep will falsely increase 8 - Low c-peptide and low BG levels can indicates liver diseases Also become high in low blood potassium.

The normal range of c peptide fasting 0. 8 -3. 1 ng/Ml Rises to 4 -8 ng/ml after meals Less than 0. 2 indicates T 1 DM

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