Evaluating C-peptide Levels in Children with Type 1 Diabetes and Its Association with Anthropometric and Clinical Variables

Abstract

Background: C-peptide, a byproduct of insulin production, plays significant physiological roles, including stabilizing blood glucose levels and protecting tissues. Its potential therapeutic role in Type 1 diabetes mellitus (T1DM) management remains underexplored, particularly in preserving β-cell function and improving glycemic control. Materials and Methods: This cross-sectional study included 69 pediatric patients with T1DM at Bo Ali Diabetes Clinic, Shiraz, Iran, from December 2022 to April 2023. Patients with a disease duration less than 2 years or metabolic comorbidities were excluded. Anthropometric measurements, HbA1c, and serum C-peptide levels were collected after three months of dietary counseling and insulin adjustment. Data were analyzed using Spearman’s correlation and linear regression. Results: The study population consisted of 69 children (mean age: 11.92 ± 3.65 years; mean disease duration: 63.13 ± 33.16 months). Serum C-peptide levels (mean: 87.02 ± 73.89 pmol/L) were inversely correlated with disease duration (ρ=-0.433, P<0.001) and HbA1c (ρ=-0.404, P=0.001). Regression analysis confirmed that both HbA1c and disease duration were significant predictors of C-peptide levels (P<0.05). However, no significant associations were observed between C-peptide and age, weight, height, or BMI. Conclusion: Reduced C-peptide levels are correlated with poorer glycemic control (greater HbA1c) and longer disease duration in children with T1DM. These findings highlight the clinical relevance of C-peptide supplementation as a potential therapeutic strategy to preserve β-cell function and improve long-term outcomes in T1DM management. Longitudinal studies are warranted to further evaluate its efficacy.