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February 1986

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

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)