Postprandial serum C-peptide to plasma glucose ratio predicts future insulin therapy in Japanese patients with type 2 diabetes

摘要

Type 2 diabetes is a progressive disease, and most patients with type 2 diabetes eventually need insulin therapy to maintain glycemic control. Recent studies have shown that early insulin treatment improved beta cell function as well as insulin resistance in patients with type 2 diabetes, suggesting that early introduction of insulin treatment may delay disease progression and be able to maintain good glycemic control thereafter. However, since predictive biomarkers for future insulin therapy have not been established, the introduction of insulin treatment is often delayed in clinical settings [2].We have recently reported that lower 2 h postprandial C-peptide immunoreactivity (CPR) to plasma glucose ratio (postprandial CPR index; PCPRI) was associated with subsequent need for insulin treatment in Japanese subjects with type 2 diabetes who were admitted to our hospital between 2000 and 2007 [3]. In that study, however, since most patients were started on insulin treatment during the baseline admission, the time-to-event relationship of insulin initiation could not be accounted for in the analysis.