Comparison of the alteration of the concentration of C-peptide in 24-h urine according to the combination patterns of hypoglycemic agents in type 2 diabetes patients.
OBJECTIVE
Urinary C-peptide (UCP) has been considered as a simple method for monitoring beta-cell function in diabetic patients clinically. The aim of the study is to compare the changes of 24-h urinary C-peptide levels according to subgroups divided by therapeutic agents for subjects with type 2 diabetes.


METHODS
In 206 participants, under treatment for type 2 diabetes, 24-h urinary C-peptide levels were assessed yearly for 3 years. All participants were subdivided into four groups according to the therapeutic agents. Changes for the measured values during the follow-up were compared between groups.


RESULTS
Mean HbA1C was 7.1% and mean 24-h UCP was 61.7 microg/24h and mean duration of diabetes was 8.7 years in all subjects at baseline. Mean 24-h UCP levels increased significantly from a baseline to at 36 months in the insulin sensitizers (IS) only group, in the IS plus sulfonylurea combination group and in IS plus insulin combination group (p<0.001), whereas in the sulfonylurea only group, we could not find statistically significant changes (p=0.152). Treatment with only IS significantly reduced fasting plasma glucose (FPG) and HbA1C level (p=0.045, p<0.001). Differences between baseline and last 24-h UCP were significantly different between-groups and this difference was more significant after adjustment in FPG, HbA1C, and the duration of diabetes (p=0.024). Especially, IS plus sulfonylurea combination group resulted in greatest increase of 24-h UCP (DeltaC-peptide=51.19 microg/24h).


CONCLUSIONS
This study suggested that IS, in mono- or in combination, significantly improved pancreatic beta-cell function, especially when combined with sulfonylurea as evidenced by the increase of 24-h UCP.
Jung
Chan-Hee
CH
Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Pyung-dong, Seoul 110-746, Korea.
Rhee
Eun-Jung
EJ
Kim
Eun-Ran
ER
Kim
Se-Yeon
SY
Shin
Hun-Sub
HS
Lee
Won-Young
WY
Oh
Ki-Won
KW
Park
Sung-Woo
SW
Kim
Sun-Woo
SW
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000652:urine*; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000652:urine*; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents