Insulin Secretion Capacity as a Crucial Feature to Distinguish Type 1
                    From Type 2 Diabetes and to Indicate the Need for Insulin Therapy – A
                    Critical Discussion of the ADA/EASD Consensus Statement on the
                    Management of Type 1 Diabetes in Adults

Andreas Fritsche

doi:10.1055/a-2016-8392

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

CC BY-NC-ND 4.0 · Exp Clin Endocrinol Diabetes 2023; 131(09): 500-503
DOI: 10.1055/a-2016-8392

Commentary

Insulin Secretion Capacity as a Crucial Feature to Distinguish Type 1 From Type 2 Diabetes and to Indicate the Need for Insulin Therapy – A Critical Discussion of the ADA/EASD Consensus Statement on the Management of Type 1 Diabetes in Adults

Authors

Andreas Fritsche

¹Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, Eberhard-Karls University Tübingen, Tübingen

²Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen

³German Center for Diabetes Research (DZD), Neuherberg

Abstract

In the recently published consensus statement on the treatment and management of type 1 diabetes issued by experts from the American (ADA) and European (EASD) diabetes societies, measurement of endogenous insulin secretion using fasting C-peptide is recommended as a diagnostic criterion. In contrast, our group recently suggested fasting C-peptide/glucose ratio (CGR) for the determination of endogenous insulin secretion. In addition, this ratio may turn out as a potential decision aid for pathophysiologically based differential therapy of diabetes. In this comment, the following points will be discussed: i) CGR as the basis of differential diagnosis of type 1 diabetes, ii) CGR as the basis of treatment decisions for or against insulin in diabetes, and iii) the ease of application of CGR in clinical practice. The use of CGR may complement the ADA/EASD recommendations and should provide a practical application in clinical practice.

Key words

insulin secretion - c-peptide - treatment - classification

Full Text

References

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