C‐peptide index at 2 h post‐meal is a useful predictor of endogenous insulin secretory capacity and withdrawal from insulin therapy in subjects with type 2 diabetes
Aims To evaluate the correlation between C‐peptide index (CPI) at 2 h post‐meal and endogenous insulin secretory capacity and to develop clinical models to predict the possibility of withdrawal from insulin therapy in patients with type 2 diabetes. Method This was a single‐centre retrospective study...
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| Veröffentlicht in: | Diabetes, obesity & metabolism obesity & metabolism, 2024-07, Vol.26 (7), p.2761-2773 |
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| creator | Iwamoto, Yuichiro Kimura, Tomohiko Shimoda, Masashi Morimoto, Yuichi Watanabe, Yuki Itoh, Takashi Sasaki, Taku Mori, Shigehito Kubo, Masato Takenouchi, Haruka Dan, Kazunori Iwamoto, Hideyuki Sanada, Junpei Fushimi, Yoshiro Katakura, Yukino Nakanishi, Shuhei Mune, Tomoatsu Kaku, Kohei Kaneto, Hideaki |
| description | Aims
To evaluate the correlation between C‐peptide index (CPI) at 2 h post‐meal and endogenous insulin secretory capacity and to develop clinical models to predict the possibility of withdrawal from insulin therapy in patients with type 2 diabetes.
Method
This was a single‐centre retrospective study of patients with type 2 diabetes admitted to our hospital. Patients were divided into a withdrawal group (n = 72) and a non‐withdrawal group (n = 75) based on whether they were able to withdraw from insulin therapy at discharge, and the correlation between CPI at 2 h after meal and diabetes‐related parameters was evaluated. In addition, we created two clinical models to predict the possibility of withdrawal from insulin therapy using machine learning.
Results
The glycated haemoglobin values of the study participants were 87.8 ± 22.6 mmol/mo. The CPI at 2 h post‐meal was 1.93 ± 1.28 in the non‐withdrawal group and 2.97 ± 2.07 in the withdrawal group (p |
| doi_str_mv | 10.1111/dom.15595 |
| format | Article |
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To evaluate the correlation between C‐peptide index (CPI) at 2 h post‐meal and endogenous insulin secretory capacity and to develop clinical models to predict the possibility of withdrawal from insulin therapy in patients with type 2 diabetes.
Method
This was a single‐centre retrospective study of patients with type 2 diabetes admitted to our hospital. Patients were divided into a withdrawal group (n = 72) and a non‐withdrawal group (n = 75) based on whether they were able to withdraw from insulin therapy at discharge, and the correlation between CPI at 2 h after meal and diabetes‐related parameters was evaluated. In addition, we created two clinical models to predict the possibility of withdrawal from insulin therapy using machine learning.
Results
The glycated haemoglobin values of the study participants were 87.8 ± 22.6 mmol/mo. The CPI at 2 h post‐meal was 1.93 ± 1.28 in the non‐withdrawal group and 2.97 ± 2.07 in the withdrawal group (p < 0.001). CPI at 2 h post‐meal was an independent predictor of withdrawal from insulin therapy. In addition, CPI at 2 h post‐meal was a better predictor than fasting CPI. Six factors associated with insulin therapy withdrawal (age, duration of diabetes, creatinine, alanine aminotransferase, insulin therapy until hospitalization, and CPI at 2 h post‐meal) were used to generate two clinical models by machine learning. The accuracy of the generated clinical models ranged from 78.3% to 82.6%.
Conclusion
The CPI at 2 h post‐meal is a clinically useful measure of endogenous insulin secretory capacity under non‐fasting conditions.</description><identifier>ISSN: 1462-8902</identifier><identifier>EISSN: 1463-1326</identifier><identifier>DOI: 10.1111/dom.15595</identifier><identifier>PMID: 38646845</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Aged ; C-Peptide - blood ; C‐peptide index ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - drug therapy ; endogenous insulin secretory capacity ; Female ; Glycated Hemoglobin - analysis ; Glycated Hemoglobin - metabolism ; Humans ; Hypoglycemic Agents - therapeutic use ; Insulin - administration & dosage ; Insulin - therapeutic use ; Insulin Secretion ; insulin therapy ; Machine Learning ; Male ; Meals ; Middle Aged ; Postprandial Period ; Retrospective Studies ; retrospective study ; type 2 diabetes ; Withholding Treatment - statistics & numerical data</subject><ispartof>Diabetes, obesity & metabolism, 2024-07, Vol.26 (7), p.2761-2773</ispartof><rights>2024 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2855-f7c4107e7718e5fa24eec1ffe0cd80b0167a20b24c5056387dd518f4da861223</cites><orcidid>0000-0003-3986-9494 ; 0000-0003-1574-0565 ; 0000-0001-8162-359X ; 0000-0002-4223-9613</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdom.15595$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdom.15595$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38646845$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iwamoto, Yuichiro</creatorcontrib><creatorcontrib>Kimura, Tomohiko</creatorcontrib><creatorcontrib>Shimoda, Masashi</creatorcontrib><creatorcontrib>Morimoto, Yuichi</creatorcontrib><creatorcontrib>Watanabe, Yuki</creatorcontrib><creatorcontrib>Itoh, Takashi</creatorcontrib><creatorcontrib>Sasaki, Taku</creatorcontrib><creatorcontrib>Mori, Shigehito</creatorcontrib><creatorcontrib>Kubo, Masato</creatorcontrib><creatorcontrib>Takenouchi, Haruka</creatorcontrib><creatorcontrib>Dan, Kazunori</creatorcontrib><creatorcontrib>Iwamoto, Hideyuki</creatorcontrib><creatorcontrib>Sanada, Junpei</creatorcontrib><creatorcontrib>Fushimi, Yoshiro</creatorcontrib><creatorcontrib>Katakura, Yukino</creatorcontrib><creatorcontrib>Nakanishi, Shuhei</creatorcontrib><creatorcontrib>Mune, Tomoatsu</creatorcontrib><creatorcontrib>Kaku, Kohei</creatorcontrib><creatorcontrib>Kaneto, Hideaki</creatorcontrib><title>C‐peptide index at 2 h post‐meal is a useful predictor of endogenous insulin secretory capacity and withdrawal from insulin therapy in subjects with type 2 diabetes</title><title>Diabetes, obesity & metabolism</title><addtitle>Diabetes Obes Metab</addtitle><description>Aims
To evaluate the correlation between C‐peptide index (CPI) at 2 h post‐meal and endogenous insulin secretory capacity and to develop clinical models to predict the possibility of withdrawal from insulin therapy in patients with type 2 diabetes.
Method
This was a single‐centre retrospective study of patients with type 2 diabetes admitted to our hospital. Patients were divided into a withdrawal group (n = 72) and a non‐withdrawal group (n = 75) based on whether they were able to withdraw from insulin therapy at discharge, and the correlation between CPI at 2 h after meal and diabetes‐related parameters was evaluated. In addition, we created two clinical models to predict the possibility of withdrawal from insulin therapy using machine learning.
Results
The glycated haemoglobin values of the study participants were 87.8 ± 22.6 mmol/mo. The CPI at 2 h post‐meal was 1.93 ± 1.28 in the non‐withdrawal group and 2.97 ± 2.07 in the withdrawal group (p < 0.001). CPI at 2 h post‐meal was an independent predictor of withdrawal from insulin therapy. In addition, CPI at 2 h post‐meal was a better predictor than fasting CPI. Six factors associated with insulin therapy withdrawal (age, duration of diabetes, creatinine, alanine aminotransferase, insulin therapy until hospitalization, and CPI at 2 h post‐meal) were used to generate two clinical models by machine learning. The accuracy of the generated clinical models ranged from 78.3% to 82.6%.
Conclusion
The CPI at 2 h post‐meal is a clinically useful measure of endogenous insulin secretory capacity under non‐fasting conditions.</description><subject>Aged</subject><subject>C-Peptide - blood</subject><subject>C‐peptide index</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>endogenous insulin secretory capacity</subject><subject>Female</subject><subject>Glycated Hemoglobin - analysis</subject><subject>Glycated Hemoglobin - metabolism</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin - administration & dosage</subject><subject>Insulin - therapeutic use</subject><subject>Insulin Secretion</subject><subject>insulin therapy</subject><subject>Machine Learning</subject><subject>Male</subject><subject>Meals</subject><subject>Middle Aged</subject><subject>Postprandial Period</subject><subject>Retrospective Studies</subject><subject>retrospective study</subject><subject>type 2 diabetes</subject><subject>Withholding Treatment - statistics & numerical data</subject><issn>1462-8902</issn><issn>1463-1326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9u1DAQhy0EoqVw4AXQHOGQ1nbixHtEy1-pqJfeI8ces66S2NiOltx65cZz8Fh9Etzd0hu-2NJ88408P0JeM3rOyrkwfjpnQmzEE3LKmrauWM3bp4c3r-SG8hPyIqUbSmlTy-45Oall27SyEafkz_bu9nfAkJ1BcLPBn6Ay8LvbXzsIPuVSnVCN4BIoWBLaZYQQ0TidfQRvAWfjv-Psl1Ta0zK6GRLqiKW8glZBaZdXULOBvcs7E9W-2Gz00yOedxhVWOG-cxluUOd0YCGvAYGDcWrAjOkleWbVmPDVw31Grj99vN5-qS6vPn_dvr-sNJdCVLbTDaMddh2TKKziDaJm1iLVRtKBsrZTnA680YKKtuzDGMGkbYySLeO8PiNvj9oQ_Y8FU-4nlzSOo5qx_LKvyxK7blNGFPTdEdXRpxTR9iG6ScW1Z7S_T6YvyfSHZAr75kG7DBOaR_JfFAW4OAJ7N-L6f1P_4erbUfkXSuieCA</recordid><startdate>202407</startdate><enddate>202407</enddate><creator>Iwamoto, Yuichiro</creator><creator>Kimura, Tomohiko</creator><creator>Shimoda, Masashi</creator><creator>Morimoto, Yuichi</creator><creator>Watanabe, Yuki</creator><creator>Itoh, Takashi</creator><creator>Sasaki, Taku</creator><creator>Mori, Shigehito</creator><creator>Kubo, Masato</creator><creator>Takenouchi, Haruka</creator><creator>Dan, Kazunori</creator><creator>Iwamoto, Hideyuki</creator><creator>Sanada, Junpei</creator><creator>Fushimi, Yoshiro</creator><creator>Katakura, Yukino</creator><creator>Nakanishi, Shuhei</creator><creator>Mune, Tomoatsu</creator><creator>Kaku, Kohei</creator><creator>Kaneto, Hideaki</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3986-9494</orcidid><orcidid>https://orcid.org/0000-0003-1574-0565</orcidid><orcidid>https://orcid.org/0000-0001-8162-359X</orcidid><orcidid>https://orcid.org/0000-0002-4223-9613</orcidid></search><sort><creationdate>202407</creationdate><title>C‐peptide index at 2 h post‐meal is a useful predictor of endogenous insulin secretory capacity and withdrawal from insulin therapy in subjects with type 2 diabetes</title><author>Iwamoto, Yuichiro ; Kimura, Tomohiko ; Shimoda, Masashi ; Morimoto, Yuichi ; Watanabe, Yuki ; Itoh, Takashi ; Sasaki, Taku ; Mori, Shigehito ; Kubo, Masato ; Takenouchi, Haruka ; Dan, Kazunori ; Iwamoto, Hideyuki ; Sanada, Junpei ; Fushimi, Yoshiro ; Katakura, Yukino ; Nakanishi, Shuhei ; Mune, Tomoatsu ; Kaku, Kohei ; Kaneto, Hideaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2855-f7c4107e7718e5fa24eec1ffe0cd80b0167a20b24c5056387dd518f4da861223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>C-Peptide - blood</topic><topic>C‐peptide index</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>endogenous insulin secretory capacity</topic><topic>Female</topic><topic>Glycated Hemoglobin - analysis</topic><topic>Glycated Hemoglobin - metabolism</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Insulin - administration & dosage</topic><topic>Insulin - therapeutic use</topic><topic>Insulin Secretion</topic><topic>insulin therapy</topic><topic>Machine Learning</topic><topic>Male</topic><topic>Meals</topic><topic>Middle Aged</topic><topic>Postprandial Period</topic><topic>Retrospective Studies</topic><topic>retrospective study</topic><topic>type 2 diabetes</topic><topic>Withholding Treatment - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iwamoto, Yuichiro</creatorcontrib><creatorcontrib>Kimura, Tomohiko</creatorcontrib><creatorcontrib>Shimoda, Masashi</creatorcontrib><creatorcontrib>Morimoto, Yuichi</creatorcontrib><creatorcontrib>Watanabe, Yuki</creatorcontrib><creatorcontrib>Itoh, Takashi</creatorcontrib><creatorcontrib>Sasaki, Taku</creatorcontrib><creatorcontrib>Mori, Shigehito</creatorcontrib><creatorcontrib>Kubo, Masato</creatorcontrib><creatorcontrib>Takenouchi, Haruka</creatorcontrib><creatorcontrib>Dan, Kazunori</creatorcontrib><creatorcontrib>Iwamoto, Hideyuki</creatorcontrib><creatorcontrib>Sanada, Junpei</creatorcontrib><creatorcontrib>Fushimi, Yoshiro</creatorcontrib><creatorcontrib>Katakura, Yukino</creatorcontrib><creatorcontrib>Nakanishi, Shuhei</creatorcontrib><creatorcontrib>Mune, Tomoatsu</creatorcontrib><creatorcontrib>Kaku, Kohei</creatorcontrib><creatorcontrib>Kaneto, Hideaki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes, obesity & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iwamoto, Yuichiro</au><au>Kimura, Tomohiko</au><au>Shimoda, Masashi</au><au>Morimoto, Yuichi</au><au>Watanabe, Yuki</au><au>Itoh, Takashi</au><au>Sasaki, Taku</au><au>Mori, Shigehito</au><au>Kubo, Masato</au><au>Takenouchi, Haruka</au><au>Dan, Kazunori</au><au>Iwamoto, Hideyuki</au><au>Sanada, Junpei</au><au>Fushimi, Yoshiro</au><au>Katakura, Yukino</au><au>Nakanishi, Shuhei</au><au>Mune, Tomoatsu</au><au>Kaku, Kohei</au><au>Kaneto, Hideaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>C‐peptide index at 2 h post‐meal is a useful predictor of endogenous insulin secretory capacity and withdrawal from insulin therapy in subjects with type 2 diabetes</atitle><jtitle>Diabetes, obesity & metabolism</jtitle><addtitle>Diabetes Obes Metab</addtitle><date>2024-07</date><risdate>2024</risdate><volume>26</volume><issue>7</issue><spage>2761</spage><epage>2773</epage><pages>2761-2773</pages><issn>1462-8902</issn><eissn>1463-1326</eissn><abstract>Aims
To evaluate the correlation between C‐peptide index (CPI) at 2 h post‐meal and endogenous insulin secretory capacity and to develop clinical models to predict the possibility of withdrawal from insulin therapy in patients with type 2 diabetes.
Method
This was a single‐centre retrospective study of patients with type 2 diabetes admitted to our hospital. Patients were divided into a withdrawal group (n = 72) and a non‐withdrawal group (n = 75) based on whether they were able to withdraw from insulin therapy at discharge, and the correlation between CPI at 2 h after meal and diabetes‐related parameters was evaluated. In addition, we created two clinical models to predict the possibility of withdrawal from insulin therapy using machine learning.
Results
The glycated haemoglobin values of the study participants were 87.8 ± 22.6 mmol/mo. The CPI at 2 h post‐meal was 1.93 ± 1.28 in the non‐withdrawal group and 2.97 ± 2.07 in the withdrawal group (p < 0.001). CPI at 2 h post‐meal was an independent predictor of withdrawal from insulin therapy. In addition, CPI at 2 h post‐meal was a better predictor than fasting CPI. Six factors associated with insulin therapy withdrawal (age, duration of diabetes, creatinine, alanine aminotransferase, insulin therapy until hospitalization, and CPI at 2 h post‐meal) were used to generate two clinical models by machine learning. The accuracy of the generated clinical models ranged from 78.3% to 82.6%.
Conclusion
The CPI at 2 h post‐meal is a clinically useful measure of endogenous insulin secretory capacity under non‐fasting conditions.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>38646845</pmid><doi>10.1111/dom.15595</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-3986-9494</orcidid><orcidid>https://orcid.org/0000-0003-1574-0565</orcidid><orcidid>https://orcid.org/0000-0001-8162-359X</orcidid><orcidid>https://orcid.org/0000-0002-4223-9613</orcidid></addata></record> |
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| ispartof | Diabetes, obesity & metabolism, 2024-07, Vol.26 (7), p.2761-2773 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged C-Peptide - blood C‐peptide index Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - drug therapy endogenous insulin secretory capacity Female Glycated Hemoglobin - analysis Glycated Hemoglobin - metabolism Humans Hypoglycemic Agents - therapeutic use Insulin - administration & dosage Insulin - therapeutic use Insulin Secretion insulin therapy Machine Learning Male Meals Middle Aged Postprandial Period Retrospective Studies retrospective study type 2 diabetes Withholding Treatment - statistics & numerical data |
| title | C‐peptide index at 2 h post‐meal is a useful predictor of endogenous insulin secretory capacity and withdrawal from insulin therapy in subjects with type 2 diabetes |
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