-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
- Cosmetic Ingredient
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
*It is only for medical professionals to read for reference.
Take you to interpret the results of the 3 most common insulin and C-peptide release tests for patients with abnormal glucose metabolism.
In the Department of Endocrinology, diabetic patients, especially newly diagnosed patients, often need to check the islet function.
The main methods to check islet function are insulin and C-peptide release tests.
These two tests are very important for diagnosing diabetes, judging the type and prognosis, and guiding treatment.
Pay attention to these 6 details of the last phase of the islet function test! How to interpret the test results of insulin and C-peptide release in this issue? Under normal circumstances, the results of insulin and C-peptide release test.
Normal fasting basal plasma insulin level is about 5-20mIU/L, and C-peptide level is about 0.
3-1.
3 nmol/L.
After oral glucose, blood sugar rises rapidly, and insulin in the blood The level of C-peptide also rises rapidly.
The peak usually occurs between 0.
5 and 1 hour after taking sugar.
The peak insulin can reach 5-10 times the fasting value, and the peak C-peptide can reach 5-8 times the fasting value.
After reaching the peak, it gradually decreases, and gradually returns to the fasting level in 2 to 3 hours.
Through the points, lines and peak values, the determination of the results of the insulin and C-peptide release test needs to be combined with the simultaneously measured blood glucose values at each time point (that is, the glucose tolerance test).
It is meaningless to look at the islet function from the blood glucose.
For the sake of intuition, we often draw the blood glucose values and insulin and C-peptide values of the above-mentioned time points (the coordinate point is 0 when fasting) into graphs, that is, the glucose tolerance curve and the insulin and C-peptide release curve.
Through analysis, to understand the patient's pancreatic islet β cell reserve function and the degree of failure.
1) Determine whether there is relative hyperinsulinemia and insulin resistance based on the relationship between the values at each time point and the simultaneously measured blood glucose level.
2) Determine whether there is a peak delay based on the time when the peak appears, and the peak delay is a characteristic of type 2 diabetes.
3) Determine the type of diabetes by observing whether the release curve is low and flat, combining the medical history and the results of the diabetes autoantibody examination to determine the type of diabetes: type 1 diabetes, latent autoimmune diabetes in adults (LADA) or type 2 diabetes.
If the type 2 diabetes is considered, the clinical characteristics of the patient (such as the length of the disease, the presence or absence of stress factors, the efficacy of hypoglycemic drugs, the usual blood sugar control status, etc.
) should be further analyzed to be caused by the inhibition of pancreatic β-cell function by hyperglycemia toxicity , Or the longer course of disease leads to pancreatic β-cell failure (if it is the former, after active treatment, pancreatic islet function is expected to improve).
Special reminder, for patients who have been treated with insulin and may produce insulin antibodies in their body, measuring insulin levels in the blood cannot evaluate their own islet function, and their own islet β-cell function should be subject to the results of the C-peptide release test.
3 common insulin and C-peptide release test results for patients with abnormal glucose metabolism 1) Reduced insulin secretion: Interpretation: The patient's glucose tolerance test indicates that the patient is a typical clinical diabetic patient; fasting serum insulin and C-peptide are lower than normal levels.
After oral administration of 100 grams of steamed bread or 75 grams of sugar water, with the increase of blood sugar level, insulin and C-peptide levels did not increase significantly, no peak appeared, and showed a low flat curve, indicating that the patient's insulin secretion is absolutely insufficient, and even β-cell failure is more common.
For patients with type 1 diabetes, LADA, or type 2 diabetes with a longer course of disease, the efficacy of oral hypoglycemic drugs alone at this time is poor, which suggests that insulin therapy must be used.
2) Increased insulin secretion type: Interpretation: Glucose tolerance test is normal; fasting serum insulin and C-peptide levels are elevated, the peak is normal after taking glucose, but the peak is delayed (the peak appears after 2 hours or 3 hours).
It suggests that patients with relatively insufficient insulin secretion and insulin resistance is the main function of pancreatic islets.
Such patients are prone to pre-meal hypoglycemia.
Although glucose tolerance is normal, they belong to the high-risk population of diabetes and are more common in obese people and early type 2 diabetes.
In treatment, life>
Interpretation: Glucose tolerance test is normal; fasting insulin and C-peptide are elevated, and the peak and peak time are normal, indicating that there is fasting insulin resistance, which is more common in overweight and obese people.
In treatment, life>
Interpretation: Glucose tolerance test indicates impaired fasting blood glucose; fasting insulin and C-peptide levels are elevated, and the peak and peak time are normal, but the level is still high at 3 hours, and it does not fall to the fasting level.
There is insulin resistance.
This is pre-diabetes , If you do not actively intervene, it may gradually progress to clinical diabetes.
Interpretation: impaired glucose tolerance, 2-hour blood glucose greater than or equal to 7.
8mmol/L less than 11.
1mmol/L; fasting insulin and C-peptide levels increase, the peak value is normal, but the peak time is delayed, and the level is still high at 3 hours without falling back At the fasting level, there is insulin resistance, which is also pre-diabetes.
If you do not actively intervene, it may gradually progress to clinical diabetes.
Interpretation: The fasting insulin and C-peptide levels are elevated, and the peak and peak time after oral sugar water are normal, which means that the pancreas is still sensitive, but the 2-hour blood glucose is greater than 11.
1mmol/L.
The glucose tolerance indicates type 2 diabetes, which means that the pancreatic islet function is still normal.
For patients with type 2 diabetes, the treatment effect of this type of patients with insulin secretagogues such as sulfonylureas is better.
3) Insulin release disorder type: Interpretation: fasting insulin and C-peptide levels can be normal, high or low, the release curve rises slowly after taking sugar, the peak is delayed and is lower than normal, and the 3-hour release curve still does not fall back to the fasting level.
Glucose tolerance test is for clinical diabetic patients.
This type of patients is better treated with insulin secretagogues such as sulfonylureas, but as the course of the disease is prolonged, their fasting insulin and C-peptide levels gradually decrease, the postprandial release curve rises more slowly, the peak shift is more obvious, and the peak value is lower In normal people, the function of pancreatic β-cells will gradually decline, so that secretagogues such as sulfonylureas can no longer be used for treatment, which is a characteristic of typical type 2 diabetes.
Take you to interpret the results of the 3 most common insulin and C-peptide release tests for patients with abnormal glucose metabolism.
In the Department of Endocrinology, diabetic patients, especially newly diagnosed patients, often need to check the islet function.
The main methods to check islet function are insulin and C-peptide release tests.
These two tests are very important for diagnosing diabetes, judging the type and prognosis, and guiding treatment.
Pay attention to these 6 details of the last phase of the islet function test! How to interpret the test results of insulin and C-peptide release in this issue? Under normal circumstances, the results of insulin and C-peptide release test.
Normal fasting basal plasma insulin level is about 5-20mIU/L, and C-peptide level is about 0.
3-1.
3 nmol/L.
After oral glucose, blood sugar rises rapidly, and insulin in the blood The level of C-peptide also rises rapidly.
The peak usually occurs between 0.
5 and 1 hour after taking sugar.
The peak insulin can reach 5-10 times the fasting value, and the peak C-peptide can reach 5-8 times the fasting value.
After reaching the peak, it gradually decreases, and gradually returns to the fasting level in 2 to 3 hours.
Through the points, lines and peak values, the determination of the results of the insulin and C-peptide release test needs to be combined with the simultaneously measured blood glucose values at each time point (that is, the glucose tolerance test).
It is meaningless to look at the islet function from the blood glucose.
For the sake of intuition, we often draw the blood glucose values and insulin and C-peptide values of the above-mentioned time points (the coordinate point is 0 when fasting) into graphs, that is, the glucose tolerance curve and the insulin and C-peptide release curve.
Through analysis, to understand the patient's pancreatic islet β cell reserve function and the degree of failure.
1) Determine whether there is relative hyperinsulinemia and insulin resistance based on the relationship between the values at each time point and the simultaneously measured blood glucose level.
2) Determine whether there is a peak delay based on the time when the peak appears, and the peak delay is a characteristic of type 2 diabetes.
3) Determine the type of diabetes by observing whether the release curve is low and flat, combining the medical history and the results of the diabetes autoantibody examination to determine the type of diabetes: type 1 diabetes, latent autoimmune diabetes in adults (LADA) or type 2 diabetes.
If the type 2 diabetes is considered, the clinical characteristics of the patient (such as the length of the disease, the presence or absence of stress factors, the efficacy of hypoglycemic drugs, the usual blood sugar control status, etc.
) should be further analyzed to be caused by the inhibition of pancreatic β-cell function by hyperglycemia toxicity , Or the longer course of disease leads to pancreatic β-cell failure (if it is the former, after active treatment, pancreatic islet function is expected to improve).
Special reminder, for patients who have been treated with insulin and may produce insulin antibodies in their body, measuring insulin levels in the blood cannot evaluate their own islet function, and their own islet β-cell function should be subject to the results of the C-peptide release test.
3 common insulin and C-peptide release test results for patients with abnormal glucose metabolism 1) Reduced insulin secretion: Interpretation: The patient's glucose tolerance test indicates that the patient is a typical clinical diabetic patient; fasting serum insulin and C-peptide are lower than normal levels.
After oral administration of 100 grams of steamed bread or 75 grams of sugar water, with the increase of blood sugar level, insulin and C-peptide levels did not increase significantly, no peak appeared, and showed a low flat curve, indicating that the patient's insulin secretion is absolutely insufficient, and even β-cell failure is more common.
For patients with type 1 diabetes, LADA, or type 2 diabetes with a longer course of disease, the efficacy of oral hypoglycemic drugs alone at this time is poor, which suggests that insulin therapy must be used.
2) Increased insulin secretion type: Interpretation: Glucose tolerance test is normal; fasting serum insulin and C-peptide levels are elevated, the peak is normal after taking glucose, but the peak is delayed (the peak appears after 2 hours or 3 hours).
It suggests that patients with relatively insufficient insulin secretion and insulin resistance is the main function of pancreatic islets.
Such patients are prone to pre-meal hypoglycemia.
Although glucose tolerance is normal, they belong to the high-risk population of diabetes and are more common in obese people and early type 2 diabetes.
In treatment, life>
Interpretation: Glucose tolerance test is normal; fasting insulin and C-peptide are elevated, and the peak and peak time are normal, indicating that there is fasting insulin resistance, which is more common in overweight and obese people.
In treatment, life>
Interpretation: Glucose tolerance test indicates impaired fasting blood glucose; fasting insulin and C-peptide levels are elevated, and the peak and peak time are normal, but the level is still high at 3 hours, and it does not fall to the fasting level.
There is insulin resistance.
This is pre-diabetes , If you do not actively intervene, it may gradually progress to clinical diabetes.
Interpretation: impaired glucose tolerance, 2-hour blood glucose greater than or equal to 7.
8mmol/L less than 11.
1mmol/L; fasting insulin and C-peptide levels increase, the peak value is normal, but the peak time is delayed, and the level is still high at 3 hours without falling back At the fasting level, there is insulin resistance, which is also pre-diabetes.
If you do not actively intervene, it may gradually progress to clinical diabetes.
Interpretation: The fasting insulin and C-peptide levels are elevated, and the peak and peak time after oral sugar water are normal, which means that the pancreas is still sensitive, but the 2-hour blood glucose is greater than 11.
1mmol/L.
The glucose tolerance indicates type 2 diabetes, which means that the pancreatic islet function is still normal.
For patients with type 2 diabetes, the treatment effect of this type of patients with insulin secretagogues such as sulfonylureas is better.
3) Insulin release disorder type: Interpretation: fasting insulin and C-peptide levels can be normal, high or low, the release curve rises slowly after taking sugar, the peak is delayed and is lower than normal, and the 3-hour release curve still does not fall back to the fasting level.
Glucose tolerance test is for clinical diabetic patients.
This type of patients is better treated with insulin secretagogues such as sulfonylureas, but as the course of the disease is prolonged, their fasting insulin and C-peptide levels gradually decrease, the postprandial release curve rises more slowly, the peak shift is more obvious, and the peak value is lower In normal people, the function of pancreatic β-cells will gradually decline, so that secretagogues such as sulfonylureas can no longer be used for treatment, which is a characteristic of typical type 2 diabetes.
