Dose the C- Peptide Level Predict Remission Phase in Type 1 Diabetes Mellitus Pediatric Patients


AbstractObjectives: To study the C-peptide level for prediction of remission phase and its role in management of newly diagnosed type 1 diabetic children.Patients and Method: A prospective case-control study was conducted on 64 newly diagnosed type 1 diabetic children. Children were classified into Group 1 (35) patients who experienced remission and Group 2 (29) patients who did not experience remission. Fasting plasma C-peptide, FPG and HbA1c were done for all patients. Results: Prevalence of remission was 0.546 (35/64). Fasting serum C- peptide of Group 1 at first, last visits and Group 2 were 163.25±120.84, 358.25±184.67 and 86.70±63.51 Pmol/l respectively; P< 0.05. Receiver Operating Characteristic (ROC) showed the prevalence of remission phase was 0.594. Plotting ROC curve for C-Peptide among patients of both groups showed Area under the Curve (AUC= 0.82). The ROC decision plot curve of best C-Peptide true predictive values was 100-200 pmol/l. Conclusions: Remission phase is prevalent in newly diagnosed type 1 diabetic children. The C-peptide is a sensitive and specific test, so that we can trust its use to predict the remission in newly diagnosed patients. The most considerable readings found 100-200 Pmol/l, as prediction cut-off limit for diagnosis of remission. The C-Peptide may assist physician in adjusting the initial insulin dose early after diagnosis of type 1 diabetes.Key Words: Type 1diabetes mellitus, remission phase, C-peptide.