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- Title
C‐peptide index at 2 h post‐meal is a useful predictor of endogenous insulin secretory capacity and withdrawal from insulin therapy in subjects with type 2 diabetes.
- Authors
Iwamoto, Yuichiro; Kimura, Tomohiko; Shimoda, Masashi; Morimoto, Yuichi; Watanabe, Yuki; Itoh, Takashi; Sasaki, Taku; Mori, Shigehito; Kubo, Masato; Takenouchi, Haruka; Dan, Kazunori; Iwamoto, Hideyuki; Sanada, Junpei; Fushimi, Yoshiro; Katakura, Yukino; Nakanishi, Shuhei; Mune, Tomoatsu; Kaku, Kohei; Kaneto, Hideaki
- Abstract
Aims: To evaluate the correlation between C‐peptide index (CPI) at 2 h post‐meal and endogenous insulin secretory capacity and to develop clinical models to predict the possibility of withdrawal from insulin therapy in patients with type 2 diabetes. Method: This was a single‐centre retrospective study of patients with type 2 diabetes admitted to our hospital. Patients were divided into a withdrawal group (n = 72) and a non‐withdrawal group (n = 75) based on whether they were able to withdraw from insulin therapy at discharge, and the correlation between CPI at 2 h after meal and diabetes‐related parameters was evaluated. In addition, we created two clinical models to predict the possibility of withdrawal from insulin therapy using machine learning. Results: The glycated haemoglobin values of the study participants were 87.8 ± 22.6 mmol/mo. The CPI at 2 h post‐meal was 1.93 ± 1.28 in the non‐withdrawal group and 2.97 ± 2.07 in the withdrawal group (p < 0.001). CPI at 2 h post‐meal was an independent predictor of withdrawal from insulin therapy. In addition, CPI at 2 h post‐meal was a better predictor than fasting CPI. Six factors associated with insulin therapy withdrawal (age, duration of diabetes, creatinine, alanine aminotransferase, insulin therapy until hospitalization, and CPI at 2 h post‐meal) were used to generate two clinical models by machine learning. The accuracy of the generated clinical models ranged from 78.3% to 82.6%. Conclusion: The CPI at 2 h post‐meal is a clinically useful measure of endogenous insulin secretory capacity under non‐fasting conditions.
- Subjects
INSULIN therapy; TYPE 2 diabetes; INSULIN; MACHINE learning; C-peptide; ALANINE aminotransferase
- Publication
Diabetes, Obesity & Metabolism, 2024, Vol 26, Issue 7, p2761
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/dom.15595