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C-peptide: difference between revisions

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11Insulin undergoes variable first-pass hepatic extraction of 40–80%, so peripheral insulin understates secretion by an amount that differs between people and with pulsatility. C-peptide avoids this and is the analyte used in any rigorous assessment of [[Beta cell function|beta-cell function]].{{r|jones2013}}11Insulin undergoes variable first-pass hepatic extraction of 40–80%, so peripheral insulin understates secretion by an amount that differs between people and with pulsatility. C-peptide avoids this and is the analyte used in any rigorous assessment of [[Beta cell function|beta-cell function]].{{r|jones2013}}
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+13Its principal limitation is renal: C-peptide is cleared by the kidney, so concentrations rise in renal impairment independently of secretion, and interpretation in that setting requires care.{{r|ada2024}}
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13== Use in assessment ==15== Use in assessment ==
14Deconvolution of a peripheral C-peptide profile using known kinetics yields a secretion rate, which is the reference approach for quantifying [[Insulin secretion|insulin secretion]].{{r|rorsman2013}} It requires timed sampling and modelling and is a research technique.{{r|jones2013}}16Deconvolution of a peripheral C-peptide profile using known kinetics yields a secretion rate, which is the reference approach for quantifying [[Insulin secretion|insulin secretion]].{{r|rorsman2013}} It requires timed sampling and modelling and is a research technique.{{r|jones2013}}
21{{reflist}}23{{reflist}}
22<ref name="jones2013">Jones AG, Hattersley AT. "The clinical utility of C-peptide measurement in the care of patients with diabetes." ''Diabetic Medicine'' 30(7):803–817 (2013). DOI:10.1111/dme.12159. PMID 23413806.</ref>24<ref name="jones2013">Jones AG, Hattersley AT. "The clinical utility of C-peptide measurement in the care of patients with diabetes." ''Diabetic Medicine'' 30(7):803–817 (2013). DOI:10.1111/dme.12159. PMID 23413806.</ref>
+25<ref name="ada2024">American Diabetes Association. "Standards of Care in Diabetes." ''Diabetes Care'' 47(Suppl 1) (2024).</ref>
23<ref name="rorsman2013">Rorsman P, Braun M. "Regulation of insulin secretion in human pancreatic islets." ''Annual Review of Physiology'' 75:155–179 (2013). PMID 22974438.</ref>26<ref name="rorsman2013">Rorsman P, Braun M. "Regulation of insulin secretion in human pancreatic islets." ''Annual Review of Physiology'' 75:155–179 (2013). PMID 22974438.</ref>
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