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C-Peptide PP

Diabetes
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Report in 4Hrs

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At Home

nofastingrequire

No Fasting Required

Details

C-Peptide is an indirect marker of insulin production by the pancreas

₹449₹1,100

59% OFF

C-Peptide PP Test Information Guide

  • Why is it done?
    • Measures endogenous insulin production by detecting C-peptide, a byproduct released when the pancreas converts proinsulin into insulin
    • Differentiates between type 1 and type 2 diabetes by assessing pancreatic beta cell function
    • Evaluates residual pancreatic function in diabetic patients to determine disease progression
    • Diagnoses factitious hypoglycemia (self-administered insulin) versus genuine pancreatic dysfunction
    • Investigates insulinoma and other pancreatic neuroendocrine tumors causing hypoglycemia
    • Monitors pancreatic beta cell recovery after pancreatic transplantation
    • Performed when patients present with symptoms of hypoglycemia, unexplained hyperglycemia, or during diabetes classification evaluation
  • Normal Range
    • Fasting C-Peptide: 0.8-3.1 ng/mL (0.27-1.03 nmol/L)
    • Stimulated C-Peptide (after glucose load): 4.0-8.0 ng/mL in healthy individuals
    • Units: ng/mL (nanograms per milliliter) or nmol/L (nanomoles per liter)
    • Normal Result: Indicates appropriate pancreatic beta cell function and normal insulin secretion in response to blood glucose
    • Low Result (<0.8 ng/mL): Suggests impaired or absent pancreatic beta cell function; characteristic of type 1 diabetes
    • High Result (>3.1 ng/mL fasting): Indicates increased insulin production; may suggest insulin resistance, type 2 diabetes, or insulinoma
    • Reference ranges may vary by laboratory; values should always be interpreted with the specific lab's reference range
  • Interpretation
    • Detectable C-Peptide with High Glucose: Indicates functional pancreatic beta cells; consistent with type 2 diabetes or prediabetes rather than type 1
    • Undetectable or Minimal C-Peptide (<0.3 ng/mL): Suggests little to no endogenous insulin production; typical of established type 1 diabetes or advanced pancreatic disease
    • Elevated C-Peptide with Low Glucose (<60 mg/dL): Suggests endogenous hyperinsulinism; may indicate insulinoma or other insulinogenic tumor
    • Low C-Peptide with Low Glucose: Rules out insulinoma; suggests factitious hypoglycemia (exogenous insulin administration) or glycogenolysis impairment
    • C-Peptide Response to Stimulation: Minimal or absent increase after glucose challenge indicates severe beta cell dysfunction; good response indicates preserved pancreatic reserve
    • Factors Affecting Results:
    • Renal function: Impaired kidney function elevates C-peptide due to decreased clearance
    • Body weight: Obesity may increase fasting C-peptide levels
    • Medications: Certain drugs like glucocorticoids and oral hypoglycemics may affect results
    • Time of sampling: Must be coordinated with glucose measurement for accurate interpretation
    • Autoantibodies: In type 1 diabetes, beta cell destruction precedes loss of C-peptide secretion
  • Associated Organs
    • Primary Organ: Pancreas (specifically the islet beta cells that produce insulin)
    • Related Organ Systems:
    • Kidneys: C-peptide is cleared by renal filtration; kidney disease affects interpretation
    • Liver: Plays a minor role in C-peptide metabolism
    • Conditions Associated with Abnormal Results:
    • Type 1 Diabetes Mellitus: Autoimmune destruction of beta cells resulting in minimal or undetectable C-peptide
    • Type 2 Diabetes Mellitus: Preserved or elevated C-peptide early in disease; may decline with progression
    • Insulinoma: Malignant or benign tumor secreting excessive insulin; elevated C-peptide during hypoglycemia
    • Pancreatic Cancer: Destruction of beta cells may lead to decreased C-peptide and secondary diabetes
    • Chronic Pancreatitis: Progressive loss of pancreatic function with declining C-peptide
    • Hemochromatosis: Iron accumulation in pancreas impairing beta cell function
    • Cystic Fibrosis-Related Diabetes: Progressive pancreatic insufficiency reducing C-peptide
    • Polycystic Ovary Syndrome (PCOS): Insulin resistance with elevated C-peptide
    • Chronic Kidney Disease: Impaired C-peptide clearance leading to falsely elevated levels
    • Potential Complications of Abnormal Results:
    • Diabetic ketoacidosis (DKA) in type 1 diabetes with undetectable C-peptide
    • Severe hypoglycemia from insulinoma or inappropriate insulin administration
    • Progressive metabolic complications from undiagnosed or poorly managed diabetes
  • Follow-up Tests
    • Recommended Based on Results:
    • Fasting Glucose and Insulin Levels: To assess glucose homeostasis and calculate HOMA-IR (insulin resistance index)
    • Oral Glucose Tolerance Test (OGTT): To evaluate glucose response and insulin secretion capacity
    • Hemoglobin A1C (HbA1C): To assess long-term glucose control over previous 2-3 months
    • Diabetes-Related Autoantibodies (GAD-65, IA-2, ICA, ZnT8): To differentiate type 1 from type 2 diabetes
    • Proinsulin Level: May be elevated in insulinoma or beta cell dysfunction
    • Serum Creatinine and eGFR: To assess renal function affecting C-peptide interpretation
    • 72-Hour Fast with Glucose, Insulin, C-Peptide, and Sulfonylurea/Meglitinide Levels: For suspected insulinoma diagnosis
    • Imaging Studies (CT, MRI, or Somatostatin Receptor Scintigraphy): If insulinoma is suspected to locate tumor
    • Monitoring Frequency:
    • Type 1 Diabetes: C-peptide monitoring may be done annually or at 1, 2, and 5 years post-diagnosis to track beta cell preservation
    • Type 2 Diabetes: Periodic assessment to monitor disease progression and beta cell function decline
    • Pancreatic Transplant: C-peptide measured periodically to assess graft function (detectable C-peptide indicates viable transplant)
    • Post-Insulinoma Surgery: Follow-up C-peptide to confirm successful tumor removal and restoration of normal glucose homeostasis
    • Complementary Tests:
    • Beta cell function assessments (e.g., stimulation tests with glucagon or arginine)
    • Lipid panel to assess metabolic risk in insulin-resistant states
    • Thyroid-stimulating hormone (TSH) to screen for other autoimmune conditions in type 1 diabetes
  • Fasting Required?
    • Fasting Status: Yes
    • Fasting Duration: 8-12 hours overnight fasting recommended for accurate fasting baseline measurement
    • Permitted During Fasting: Water only; no food, beverages, or supplements
    • Stimulated Testing: For stimulated C-peptide testing (post-glucose challenge or post-meal), specific protocols may be used; instructions provided by the laboratory
    • Medications to Discuss with Healthcare Provider:
    • Do not discontinue insulin or other diabetes medications without medical guidance
    • Glucocorticoids may interfere with results and should be reported
    • Certain antibiotics and antifungals may affect interpretation; inform lab of current medications
    • Patient Preparation Instructions:
    • Begin fasting from midnight or at least 8-12 hours before blood draw
    • Drink water as usual but avoid any other beverages
    • Minimize physical activity or stress the morning of the test as this may affect glucose levels
    • Schedule blood draw in early morning when cortisol and glucose are most stable
    • Bring insurance card and photo identification to the testing facility
    • For stimulated testing, consume glucose load or meal as directed by healthcare provider at specified time

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