Key points are not available for this paper at this time.
Abstract Background: C‐peptide measurement is a well‐recognised tool for distinguishing individuals with insulin deficiency from those with retained insulin secretion; however, it is not routinely performed across the UK. Aims: This study aimed to evaluate the feasibility and efficacy of routine urinary c‐peptide testing in a district general hospital type 1 diabetes clinic. Methods: In this single‐centre study, adults with type 1 diabetes for at least 3 years were offered random urine c‐peptide–to–creatinine ratio (UCPCR) testing during routine clinic review. A UCPCR of >0.2 prompted further evaluation of the individual and their diabetes treatment. Results: Of 200 recruited individuals, 172 (87%) submitted a urine sample. Of the 172 individuals, 26 (15%) had a UCPCR of >0.2, which prompted a review of their diagnosis and treatment strategies, and 12 (7%) had a UCPCR of >0.6, suggesting significant inherent insulin secretion and a likelihood of positive response to alternative or additional pharmacological agents. Conclusions: Urinary c‐peptide level testing performed routinely at a district general hospital type 1 diabetes clinic is practical. It can alter patient clinical outcomes, lead to more appropriate and effective pharmacological treatments and ensure appropriate use of expensive technologies.
Christopher Redford (2024) studied this question.