Conference abstract
Performance of home-collected dried blood spot C-peptide measurement in assessing endogenous insulin secretion in children and adolescents with young-onset diabetes in Cameroon
Pan African Medical Journal - Conference Proceedings. 2023:17(2).04
Jun 2023.
doi: 10.11604/pamj-cp.2023.17.2.1844
Archived on: 04 Jun 2023
Contact the corresponding author
Keywords: Young-onset diabetes, dried blood spot, endogenous insulin secretion, C-peptide
Oral presentation
Performance of home-collected dried blood spot C-peptide measurement in assessing endogenous insulin secretion in children and adolescents with young-onset diabetes in Cameroon
Jean-Claude Katte1,2,&, Mesmin Dehayem1, Beverly Shields2, Moffat Nyirenda3, Andrew Hattersley2, Angus Jones2,4, Timothy McDonald2,5, Eugene Sobngwi1,6
1Jean-Claude Katte*1,2,&+Mesmin Dehayem*1+Beverly Shields*2+Moffat Nyirenda*3+Andrew Hattersley*2+Angus Jones*2,4+Timothy McDonald*2,5+Eugene Sobngwi*1,6
&Corresponding author
Introduction: C-peptide measurement during a mixed meal test remains the reference in assessing endogenous insulin secretion in people with diabetes. It is however expensive and cumbersome in practice. We examined the value of home-collected dried blood spot (DBS) C-peptide measurements in assessing endogenous insulin secretion in participants with young-onset insulin-treated diabetes.
Methods: we compared and assessed the diagnostic performances of home fasting and post-meal (post-breakfast, post-lunch, and post-supper) dried blood spot C-peptide measurements with standardized mixed meal test 90-minute blood C-peptide from 37 individuals: median (interquartile range) age 16 (15, 19) years and, diabetes duration 1.2 (0.1, 2.9) years. C-peptide was measured using a single molecule array assay, which has a lower limit of detection (1.50) pmol/L.
Results: the median (interquartile range) fasting, post-breakfast, post-lunch, post-supper, and mixed meal test 90-minute blood C-peptide were 57 (16, 144), 129 (26, 485), 102 (31, 250), 80 (26, 219) and 171 (100, 418) pmol/L respectively. Post home-meal DBS C-peptide levels were strongly correlated with stimulated blood C-peptide at 90 minutes from the mixed meal tolerance test, r=0.90-0.91, with a lower correlation for fasting DBS (r=0.77). For identifying participants with clinically relevant C-peptide levels (MMTT C-peptide <200pmol/L (near absolute insulin deficiency) and <600pmol/L (insulin requirement and type 1 diabetes) identical post breakfast DBS cut-offs had AUC ROC 0.92(95%CI 0.82-1.00) and 0.98 (95%CI 0.94-1.00), with sensitivity/specificity 85.7% (63.7-97.0) /75.0% (47.6-92.7) and 90.6% (75.0-98.0)/100% (47.8-100.0) respectively.
Conclusion: a single home-collected fasting or post-meal DBS C-peptide level allows accurate assessment of endogenous insulin secretion in people with young-onset insulin-treated diabetes.
Performance of home-collected dried blood spot C-peptide measurement in assessing endogenous insulin secretion in children and adolescents with young-onset diabetes in Cameroon
Jean-Claude Katte1,2,&, Mesmin Dehayem1, Beverly Shields2, Moffat Nyirenda3, Andrew Hattersley2, Angus Jones2,4, Timothy McDonald2,5, Eugene Sobngwi1,6
1Jean-Claude Katte*1,2,&+Mesmin Dehayem*1+Beverly Shields*2+Moffat Nyirenda*3+Andrew Hattersley*2+Angus Jones*2,4+Timothy McDonald*2,5+Eugene Sobngwi*1,6
&Corresponding author
Introduction: C-peptide measurement during a mixed meal test remains the reference in assessing endogenous insulin secretion in people with diabetes. It is however expensive and cumbersome in practice. We examined the value of home-collected dried blood spot (DBS) C-peptide measurements in assessing endogenous insulin secretion in participants with young-onset insulin-treated diabetes.
Methods: we compared and assessed the diagnostic performances of home fasting and post-meal (post-breakfast, post-lunch, and post-supper) dried blood spot C-peptide measurements with standardized mixed meal test 90-minute blood C-peptide from 37 individuals: median (interquartile range) age 16 (15, 19) years and, diabetes duration 1.2 (0.1, 2.9) years. C-peptide was measured using a single molecule array assay, which has a lower limit of detection (1.50) pmol/L.
Results: the median (interquartile range) fasting, post-breakfast, post-lunch, post-supper, and mixed meal test 90-minute blood C-peptide were 57 (16, 144), 129 (26, 485), 102 (31, 250), 80 (26, 219) and 171 (100, 418) pmol/L respectively. Post home-meal DBS C-peptide levels were strongly correlated with stimulated blood C-peptide at 90 minutes from the mixed meal tolerance test, r=0.90-0.91, with a lower correlation for fasting DBS (r=0.77). For identifying participants with clinically relevant C-peptide levels (MMTT C-peptide <200pmol/L (near absolute insulin deficiency) and <600pmol/L (insulin requirement and type 1 diabetes) identical post breakfast DBS cut-offs had AUC ROC 0.92(95%CI 0.82-1.00) and 0.98 (95%CI 0.94-1.00), with sensitivity/specificity 85.7% (63.7-97.0) /75.0% (47.6-92.7) and 90.6% (75.0-98.0)/100% (47.8-100.0) respectively.
Conclusion: a single home-collected fasting or post-meal DBS C-peptide level allows accurate assessment of endogenous insulin secretion in people with young-onset insulin-treated diabetes.
