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February 1986

Clinical Evaluation of Determinants of Glycemic Control: A New Approach Using Serum Glucose, C-Peptide, and Body Mass Indexes in Type II Diabetic Patients

Author Affiliations

From the Division of Endocrinology and Metabolism, Department of Medicine, The Ohio State University Hospitals, Columbus.

Arch Intern Med. 1986;146(2):281-285. doi:10.1001/archinte.1986.00360140091014

• We evaluated the clinical characteristics and relationships between values of serum glucose, C-peptide, and body mass Index (BMI) in 40 type II diabetic patients. Patients were divided into three groups according to the drug therapy: group A (n =16), oral sulfonylurea agent; group B(n=16), insulin alone; and group C (n=8), combined insulin and oral agent. The relationships between the various factors were expressed as ratios (C-peptide/BMI, glucose/BMI, and C-peptide/glucose scores). Using glycosylated hemoglobin (HbA1) value of less than 10.5% to denote response to therapy, each group was subdivided into responders and nonresponders. Comparing the data in group A, mean (±SEM) fasting serum glucose levels were significantly lower in responders vs nonresponders. The mean HbA1 levels were 8.59±0.54% vs 12.34±0.34%, respectively. The C-peptide/BMI scores were 7.4 ±1.0 vs 8.14±1.2; C-peptide/glucose scores, 1.73 ± 0.27 vs 0.81 ±0.12; and glucose/BMI scores, 493±54 vs 1,082±168, respectively. The responders and nonresponders in group B had values similar to those of group A. Group C patients had data biochemically similar to those of the nonresponders in groups A and B. The responders in each group were characterized by serum glucose levels less than 200 mg/dL, C-peptide/glucose score greater than 1, and glucose/BMI score less than 700. The nonresponders had mean serum glucose levels greater than 200 mg/dL, C-peptide/glucose score less than 1, and glucose/ BMI score greater than 700. These simple calculated scores validate the importance of glucose/C-peptide/BMI interrelationships in ambulatory diabetic patients.

(Arch Intern Med 1986;146:281-285)