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Urinary C-peptide creatinine ratio to differentiate type 2 diabetes mellitus from type 1 in pediatric patients

Wafaa Elzahar1, Ahmed Arafa1, Amira Youssef2

  • 1Pediatric Department, Faculty of Medicine, Tanta University Hospital, El motasem street No 6, Tanta, Egypt.

European Journal of Pediatrics
|February 14, 2020
PubMed

Insights

Urinary C-peptide to creatinine ratio (UCPCR) effectively distinguishes type 2 diabetes mellitus (T2DM) from type 1 DM (T1DM) in children. This noninvasive marker shows high sensitivity and specificity, aiding accurate pediatric diabetes diagnosis.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Research

Background:

  • Type 2 diabetes mellitus (T2DM) is often misdiagnosed in children as type 1 DM (T1DM), leading to inappropriate insulin treatment.
  • Urinary C-peptide to creatinine ratio (UCPCR) is a validated measure of pancreatic beta-cell function and endogenous insulin production.

Purpose of the Study:

  • To evaluate the diagnostic utility of UCPCR in differentiating T2DM from T1DM in pediatric patients.
  • To establish an optimal UCPCR cutoff value for distinguishing between T1DM and T2DM in children.

Main Methods:

  • Assessed UCPCR from post-lunch urine samples in 50 children with T1DM and 30 with T2DM (disease duration ≥2 years, no renal impairment).
  • Measured fasting and postprandial C-peptide levels in all participants.
  • Utilized Receiver Operating Characteristic (ROC) curve analysis to determine the optimal UCPCR cutoff.

Main Results:

  • UCPCR levels were significantly lower in children with T1DM compared to those with T2DM (P < 0.001).
  • UCPCR demonstrated high diagnostic accuracy, with a sensitivity of 97% and specificity of 88% at a cutoff of ≥0.28 nmol/nmol.
  • Significant correlations were observed between UCPCR and C-peptide levels, age of onset, HbA1c, and DM duration.

Conclusions:

  • UCPCR serves as a reliable, noninvasive, and easily accessible biomarker for differentiating T2DM from T1DM in pediatric populations.
  • The established UCPCR cutoff value aids in accurate diagnosis, potentially improving treatment strategies for children with diabetes.

Keywords:
ChildrenT1DMT2DMUCPCR

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