A Novel Method to Evaluate Insulin Sensitivity by Combining Continuous Glucose Monitoring and Urinary C‐Peptide Excretion

AIM: Assessing insulin sensitivity is a central component of clinical research in metabolism. Although considered the gold standard, the euglycemic-hyperinsulinemic clamp evaluates insulin sensitivity under non-physiological conditions and is highly burdensome and costly, thereby prompting the development of alternative methods. The 24-h urinary C-peptide excretion rate adjusted for energy intake is a surrogate marker of insulin sensitivity in non-diabetic adults. We hypothesized that the combination of 24-h continuous glucose monitoring (CGM) and 24-h urinary C-peptide excretion (24 h-glycemia/C-peptide ratio) would be a better predictor of insulin sensitivity than the C-peptide excretion rate adjusted for energy intake or other widely accepted indexes. METHODS: (high-dose)]. RESULTS: ranging from 0.108 to 0.174 for the clamp high dose. CONCLUSIONS: These results suggest that the 24 h-glycemia/C-peptide ratio is a promising simple, inexpensive, non-invasive, and physiological marker of insulin sensitivity that deserves further investigation.