Conference abstract
Performance of home-collected dried blood spot C-peptide measurement in assessing endogenous insulin secretion in children and adolescents diagnosed with type 1 diabetes in Cameroon
Pan African Medical Journal - Conference Proceedings. 2023:19(13).23
Nov 2023.
doi: 10.11604/pamj-cp.2023.19.13.1957
Archived on: 23 Nov 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 diagnosed with type 1 diabetes in Cameroon
Jean Claude Katte1,2,3,&, Mesmin Dehayem1, Beverly Shields3, Moffat Nyirenda4, Andrew Hattersley3, Angus Jones3,5, Timothy McDonald3,5, Eugene Sobngwi1,2,7
1National Obesity Centre and Endocrinology and Metabolic Diseases Unit, Yaoundé Central Hospital, Yaoundé, Cameroon, 2Department of Non-Communicable Diseases, RSD Institute, Yaoundé, Cameroon, 3Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Exeter, United Kingdom, 4Department of Medicine, Non-Communicable Diseases Theme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda, 5Macleod Diabetes and Endocrine Centre, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom, 6Academic Department of Clinical Biochemistry, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom, 7Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
&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 diagnosed with type 1 diabetes in Cameroon
Jean Claude Katte1,2,3,&, Mesmin Dehayem1, Beverly Shields3, Moffat Nyirenda4, Andrew Hattersley3, Angus Jones3,5, Timothy McDonald3,5, Eugene Sobngwi1,2,7
1National Obesity Centre and Endocrinology and Metabolic Diseases Unit, Yaoundé Central Hospital, Yaoundé, Cameroon, 2Department of Non-Communicable Diseases, RSD Institute, Yaoundé, Cameroon, 3Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Exeter, United Kingdom, 4Department of Medicine, Non-Communicable Diseases Theme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda, 5Macleod Diabetes and Endocrine Centre, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom, 6Academic Department of Clinical Biochemistry, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom, 7Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
&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.
