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Considering insulin secretory capacity as measured by a fasting c-peptide/glucose ratio in selecting glucose-lowering medications.

Exp. Clin. Endocrinol. Diabet. 130, 200-204 (2022)
Verlagsversion DOI PMC
Open Access Hybrid
Creative Commons Lizenzvertrag
Type 2 diabetes mellitus is a heterogeneous disease. Recently introduced new subclassifications promise more efficacious, tailored treatments which could complement current guidelines. In the differentiation of the new diabetes subphenotypes, assessment of insulin secretion is one of the essential components. Based on a large number of insulin secretion measurements, we propose fasting C-peptide/glucose ratio (CGR) as an adequate and practicable estimate of insulin secretion. CGR discriminates insulin deficiency from insulin hypersecretion. We suggest using insulin secretion, determined from CGR, as an essential input for therapeutic decisions at the beginning or modification of diabetes treatment. Furthermore, we propose 3 practical steps to guide decisions in the subtype-specific therapy of diabetes mellitus. The first step consists of detecting insulin deficiency indicated by a low CGR with the need for immediate insulin therapy. The second step is related to high CGR and aims at lowering cardiovascular risk associated with diabetes. The third step is the consideration of a de-escalation of glucose-lowering therapy in individuals with mild diabetes subphenotypes.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Review
Schlagwörter Insulin Secretion ; Classification ; Subphenotype ; C-peptide ; Treatment; Association; Inhibitors; Disease; Life
Sprache englisch
Veröffentlichungsjahr 2022
Prepublished im Jahr 2020
HGF-Berichtsjahr 2020
ISSN (print) / ISBN 0947-7349
e-ISSN 1439-3646
Quellenangaben Band: 130, Heft: 3, Seiten: 200-204 Artikelnummer: , Supplement: ,
Verlag Thieme
Verlagsort Stuttgart
Begutachtungsstatus Peer reviewed
POF Topic(s) 90000 - German Center for Diabetes Research
Forschungsfeld(er) Helmholtz Diabetes Center
PSP-Element(e) G-502400-001
Scopus ID 85091767959
PubMed ID 32947641
Erfassungsdatum 2020-11-11