Validation of a single-sample urinary C-peptide creatinine ratio as a reproducible alternative to serum C-peptide in patients with Type 2 diabetes
Abstract
Diabet. Med. 29, 90–93 (2012) Aims Serum C‐peptide can be used in Type 2 diabetes as a measure of endogenous insulin secretion, but practicalities of collection limit its routine clinical use. Urine C‐peptide creatinine ratio is a non‐invasive alternative that is stable for at least 3 days at room temperature in boric acid preservative. We aimed to assess the utility of urine C‐peptide creatinine ratio in individuals with Type 2 diabetes as an alternative to serum C‐peptide. Methods We assessed, in 77 individuals with Type 2 diabetes, the reproducibility of, and correlations between, fasting and postprandial urine C‐peptide creatinine ratio and serum C‐peptide, and the impact of renal impairment (estimated glomerular filtration rate < 60 ml min−1 1.73 m−2) on these correlations. Results Urine C‐peptide creatinine ratio was at least as reproducible as serum C‐peptide [fasting coefficient of variation mean (95% CI): 28 (21–35)% vs. 38 (26–59)% and 2‐h post‐meal 26 (18–33)% vs. 27 (20–34)%. Urine C‐peptide creatinine ratio 2 h post‐meal was correlated with stimulated serum C‐peptide, both the 2‐h value (r = 0.64, P < 0.001) and the 2‐h area under the C‐peptide curve (r = 0.63, P < 0.001). The association seen was similar in patients with and without moderate renal impairment (P = 0.6). Conclusions In patients with Type 2 diabetes, a single urine C‐peptide creatinine ratio is a stable, reproducible measure that is well correlated with serum C‐peptide following meal stimulation, even if there is moderate renal impairment. Urine C‐peptide creatinine ratio therefore has potential for use in clinical practice in the assessment of Type 2 diabetes.
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UCPCR requires only a single spot urine sample and remains stable for 3 days at room temperature, which makes large community studies feasible because samples can be posted.
“UCPCR involves a single, spot urine measurement and has the advantage of long term stability (3 days) at room temperature which facilitates large scale community studies as samples can be posted.”
From Most people with long-duration type 1 diabetes in a large population-based study are insulin microsecretors (2015) · cites this paper as [5]
Urine post-meal C-peptide creatinine ratio is an alternative to serum C-peptide testing.
“Measurement of urine post meal C-peptide creatinine ratio (UCPCR) is an alternative to serum C-peptide testing(4–7).”
From Most people with long-duration type 1 diabetes in a large population-based study are insulin microsecretors (2015) · cites this paper as [5]
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- Authors
- Bowman, P., McDonald, T. J., Shields, B. M., Knight, B. A., & Hattersley, A. T.
- Affiliations
- University of Exeter (GB)
- Corresponding author
- Hattersley, A. T.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2011-12-07
- Volume
- 29
- Issue
- 1
- Pages
- 90-93
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W1939888620
- Cited by
- 40
- References
- 12
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 5 · 2015: 1 · 2014: 3 · 2013: 4 · 2012: 3
- FWCI
- 3.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Royal Devon and Exeter Research Repository (Royal Devon and Exeter) (submittedVersion)
- Funders
- National Institute for Health and Care Research
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- urinary C-peptide, type 2 diabetes, endogenous insulin secretion, reproducibility, renal dysfunction, estimated glomerular filtration rate, non-invasive biomarkers, postprandial C-peptide
- MeSH terms
- Insulin Secretion, Adult, C-Peptide, Creatinine, Diabetes Mellitus, Type 2, Fasting, Female, Glomerular Filtration Rate, Humans, Insulin, Male, Predictive Value of Tests, Reproducibility of Results, Biomarkers, Postprandial Period
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