Besser Rachel E J
Peninsula NIHR Clinical Research Facility, Peninsula Medical School, University of Exeter, Exeter, UK.
Pediatr Endocrinol Rev. 2013 Jul;10(4):494-502.
Diabetes results from insulin deficiency but despite this endogenous insulin secretion is infrequently measured. C-peptide is not present in synthetic insulin so it's presence indicates endogenous secretion. One of the key roles for measuring C-peptide in childhood is to assist in the diagnosis of diabetes subtypes, which in turn determines appropriate management. It is also useful in Type 1 diabetes to monitor disease course, both in clinical practice and in trials following intervention with disease modifying agents. Measuring C-peptide routinely in Type 1 diabetes provides valuable information to the patient and clinician about glucose variability, risk of hypoglycemia and ketoacidosis. Newer more practical methods of C-peptide determination are now available to allow assessment of endogenous insulin secretion in routine clinical practice. We review the physiology of insulin secretion, the essential roles and methods for C-peptide determination in blood and in urine.
糖尿病是由胰岛素缺乏引起的，但尽管如此，内源性胰岛素分泌却很少被检测。合成胰岛素中不存在C肽，因此其存在表明内源性分泌。在儿童期检测C肽的关键作用之一是协助诊断糖尿病亚型，这反过来又决定了适当的治疗方法。在1型糖尿病中，它对于监测疾病进程也很有用，无论是在临床实践中还是在使用疾病修饰剂进行干预后的试验中。在1型糖尿病中常规检测C肽可为患者和临床医生提供有关血糖变异性、低血糖和酮症酸中毒风险的有价值信息。现在有更新的、更实用的C肽测定方法，可用于在常规临床实践中评估内源性胰岛素分泌。我们综述了胰岛素分泌的生理学、血液和尿液中C肽测定的重要作用及方法。
