Relationship of C-peptide levels to duration of Type 1 diabetes – A study from Sindh, Pakistan
Open accessAbstract
Objective: To determine the relationship of C-peptide levels with duration of type 1 diabetes mellitus. Methods: This prospective study was conducted at Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University (BMU), Karachi-Pakistan from December 2013 to December 2015. A total of 184 subjects were recruited during the study period, 100 in Group-A and 84 in Group-B. Subjects clinically diagnosed with type 1 diabetes Mellitus (T1DM) were categorized into two groups based on duration of diabetes: Group-A (with ≤1-year duration of diabetes) and Group-B (with >1-year duration of diabetes). Ninety-nine of the 100 enrolled subjects in Group-A were diagnosed as having T1DM, with one subject who presented at 11.9 years of age and diagnosed with T2DM excluded from this study. Blood samples were drawn for biochemical parameters. Data for baseline characteristics and clinical parameters (HbA1c and C-peptide) were obtained from hospital management system of BIDE. Results: Fifty-seven (57.6%) subjects in Group-A, and 39 (46.4%) in Group-B were males. Mean±SD duration of diabetes (years) was 0.64±0.6 (range 0-1) in Group-A, and 7.65±5.5 (range 1-23) in Group-B. Family history of T1DM and T2DM was 1(1%) and 27(27.3%) in Group-A, and 8(9.52%) and 21(25%) in Group-B, respectively. Twenty-one (21.2%) subjects presented in diabetic ketoacidosis (DKA) in Group-A and 18(21.4%), in Group-B. Mean±SD for HbA1c was non-significantly higher in Group-A 11.12±2.31 compared to Group-B 10.42±1.45. Mean±SD for C-peptide was 1.91±1.53 ng/mL (0.60±0.481 nmol/L) in Group-A, and 1.82±1.01 (0.57±0.32 nmol/L) in Group-B (p=0.984). Conclusion: The study found that subjects with longer duration of T1DM had non-significantly decreased C-peptide levels compared to a group in which C-peptide was measured at or soon after diagnosis. Furthermore, C-peptide levels in many subjects with longer duration were higher than expected in classic T1DM. doi: https://doi.org/10.12669/pjms.36.4.1531 How to cite this:Fawwad A, Waris N, Askari S, Ogle G, Ahmedani MY, Basit A. Relationship of C-peptide levels to duration of Type 1 diabetes – A study from Sindh, Pakistan. Pak J Med Sci. 2020;36(4):765-769. doi: https://doi.org/10.12669/pjms.36.4.1531 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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C-peptide measurements and other advanced diagnostics and phenotyping are being implemented in youth in less advantaged regions who have been newly diagnosed with diabetes mellitus.
“However, this picture is changing with C-peptide measurements and other advanced diagnostics and phenotyping being implemented in youth in less advantaged regions who have been newly diagnosed with diabetes mellitus93–98.”
From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [93]
The Methods and Results (pages unavailable) report C-peptide and HbA1c measurements in a Pakistan cohort whose ≤1-year diabetes group was predominantly young. The Discussion’s limitations section says antibody and insulin testing in that group was published separately, while some other assays were not done. This supports an example of measurements in recently diagnosed youth, but not the broader claim that advanced diagnostics and phenotyping are being implemented across less advantaged regions. (LLM, conf=0.85)
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The epidemiology of type 1 diabetes mellitus in older adults
Tomic, D., Harding, J. L., Jenkins, A. J., Shaw, J. E., & Magliano, D. J. (2025) · Nature Reviews Endocrinology · doi:10.1038/s41574-024-01046-z · Cited by 58 · see citing works
- Authors
- Fawwad, A., Waris, N., Askari, S., Ogle, G., Ahmedani, M. Y., & Basit, A.
- Affiliations
- Baqai Medical University (PK)
- University of Karachi (PK)
- Corresponding author
- Fawwad, Asher
- Venue
- Pakistan Journal of Medical Sciences
- Publisher
- Pakistan Journal of Medical Sciences
- Published
- 2020-05-14
- Volume
- 36
- Issue
- 4
- Pages
- 765-769
- ISSN
- 1681-715X (ISSN-L)
- 1682-024X
- PMC
- PMC7260921
- OpenAlex
- W3016563825
- Cited by
- 3
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Pakistan Journal of Medical Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- type 1 diabetes, C-peptide, diabetes duration, HbA1c, beta-cell function, early-onset type 1 diabetes, diabetic ketoacidosis, family history of diabetes, Sindh, Pakistan, South Asia, type 2 diabetes misdiagnosis, glycemic control, insulin sensitivity, insulin sensitivity index, insulin resistance index
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