C-Peptide – The Most Important Blood Test for Diabetes
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Have you ever heard of the C-Peptide test?
It turns out that your C-Peptide is an important
indicator of your diabetes health, and one
the most important of all diabetes biomarkers.
In this video, we'll cover the basics of C-Peptide
biology, explain what it tells you about your
body's ability to secrete insulin, how it
helps you understand what type of diabetes
are you living
with, as well as where and how to get your
C-Peptide tested easily.
What Exactly is C-Peptide?
When the beta cells in your pancreas secrete
insulin, they secrete it as a molecule known
as
"proinsulin."
Proinsulin is an immature version of insulin,
that's comprised of an alpha-chain, a
beta-chain, and a C-peptide connector.
Now, when C-peptide is removed from the proinsulin
molecule, proinsulin turns into insulin.
And
insulin has very specific and powerful biological
activity in your blood and tissues.
Insulin and C-peptide are made in equal amounts,
and C-peptide remains in you blood for
substantially longer periods of time than
insulin.
What this means is simple: C-peptide and
insulin are present in pancreatic beta cells,
and in your blood, in equal amounts, however
C-
peptide has a substantially longer half-life
than insulin, 20-30 minutes vs. 3-5 minutes
for insulin.
This means that C-peptide remains in your
blood for approximately 5 times as long as
insulin,
and is therefore present in your blood at
approximately 5 times the concentration
And because insulin is degraded quickly, measuring
your C-Peptide value is easier, because it
sticks around for a longer period of time,
and is used as a surrogate for the amount
of insulin
that your pancreas actually produces.
Why is your C-Peptide important?
Because C-Peptide is directly related to insulin
production, understanding whether beta cells
are
capable of secreting sufficient amounts of
insulin to meet your body's metabolic needs
is an
absolutely crucial piece of information.
In fact, understanding your C-Peptide value
is so important, that researchers believe
it to be the
most suitable measurement for assessing endogenous
insulin secretion.
Therefore, knowing
your C-Peptide level is crucial in understanding
what type of diabetes you have.
Since the treatment of type 1, type 1.5, prediabetes,
type 2, and gestational diabetes, each
require different treatment plans, being misdiagnosed
with an incorrect type of diabetes can
lead to an improper course of treatment, years
of frustration, and rapidly declining health.
An accurate C-Peptide measurement will provide
you, and your doctor, with a quantitative
assessment of the ability of your pancreatic
beta cells to secrete insulin.
Question #1: What Type of Diabetes Are You
Actually Living With?
Every year, millions of people are misdiagnosed
with type 2 diabetes rather than type 1 diabetes
or type 1.5 diabetes because they fail to
measure their C-peptide value at an early
stage after
diagnosis.
The C-peptide test will tell you what type
of diabetes you are actually living with,
and will help
you differentiate between an autoimmune version
of diabetes (with extremely low insulin
production) or a lifestyle-related diabetes
(with medium to high insulin production).
Recent guidelines dictate that a C-peptide
test should be used when there is doubt about
what
type of diabetes a patient is living with.
In addition, a recent systematic review suggested
that
the C-peptide test be used as the principal
baseline measure of insulin deficiency.
Knowing your C-peptide value can determine
the entire course of your diabetes treatment,
and
allow you to differentiate between "insulin
sufficient" and "insulin deficient."
Although it is
possible to make an educated guess about what
type of diabetes you are living with, a C-
peptide gives you and your doctor much more
accurate information into your overall diabetes
health.
Question #2: Are You Living with Autoimmune
Diabetes?
If you are living with an autoimmune version
of diabetes (either type 1 or type 1.5 diabetes),
then your C-peptide value will most likely
be significantly lower than if you are living
prediabetes
or type 2 diabetes.
But what exactly is type 1.5 diabetes?
Type 1.5 diabetes is increasing in prevalence
around the
world, and often referred to as Latent Autoimmune
Diabetes in Adults (LADA).
Once considered rare conditions, type 1.5
diabetes has been on the rise since the 1950's.
Living with type 1.5 diabetes, which is an
adult-onset, slow-progressing version of type
1
diabetes, means that your pancreas is still
capable of producing insulin, but the presence
of one
or more autoantibodies against beta cells
leads to a slow and progressive decline of
beta cells
over time.
Now, LADA has characteristics of both type
1 diabetes and type 2 diabetes and is often
misdiagnosed as other forms of diabetes, resulting
is the wrong treatment protocol.
It is currently unknown how many people are
living with 1 diabetes around the world, and
how
many people have been misdiagnosed with other
forms of diabetes, but some estimate it could
be as many as 1 out of every 10 patients living
with diabetes, and some researchers believe
that type 1.5 diabetes is the most prevalent
form of all autoimmune diabetes in general.
Therefore, more prevalent than type 1 diabetes.
The Immunology of Diabetes Society has established
3 main criteria for establishing a diagnosis
of LADA, including:
* Being greater than 30 years at the time
of diagnosis
* Testing positive for at least 1 islet cell
autoantibody
* Having no insulin requirement for at least
6 months after diagnosis
In contrast, those living with type 1 diabetes
experience a "severe and rapid loss of insulin
secretion" characterized by multiple autoantibodies
and a dangerously low C-peptide value.
An overwhelming majority of those living with
type 1.5 diabetes test positive for only one
autoantibody, resulting in a slow-progressing
loss of insulin secretion over time.
Those living with type 1 diabetes often require
exogenous insulin almost immediately after
diagnosis, whereas those with type 1.5 diabetes
may not require insulin therapy for 6 months
and 5 years after diagnosis.
It turns out that people with LADA are often
misdiagnosed with type 2 diabetes for three
main
reasons:
* Diabetes onset occurs during adulthood
* Beta cell destruction and symptoms of the
disease occur over the course of time
* Patients and doctors might have an incomplete
understanding of their autoimmune
status, and are lacking a diabetes antibody
panel to test for the autoantibodies known
as:
o GADA (GAD antibody)
o IAA (Insulin autoantibody)
o IA-2A (Antibodies to insulinoma-associated
antigen-2)
o ICA (Islet cell antibody)
o ZnT8A (Zinc-transporter 8 antibody)
Type 1.5 diabetes is also likely in patients
diagnosed with type 2 diabetes as an adult
who are
lean and do not have any symptoms of the metabolic
syndrome, especially if that patient follows
a low-fat, plant-based, whole-food diet and
is physically active.
Because a low-fat, plant-based, whole-food
lifestyle is so effective at preventing and
reversing
type 2 diabetes, if you are unable to control
your blood glucose after 3 months, then we
recommend testing your C-Peptide and getting
a diabetes antibody panel immediately.
We recommend getting your C-Peptide tested
first.
Once you have that information, you can
decide if it's worth the time and effort to
test for diabetes antibodies.
Question #3: How Much Damage Have Your Beta
Cells Accumulated
Over Time?
Knowing how much damage has been done to your
beta cells over time is an important
determinant of whether your body requires
exogenous insulin, or not.
If your beta cells are still functioning properly,
a low-fat, plant-based, whole-food diet combined
with frequent exercise and adequate sleep
can help you achieve non-diabetic blood glucose
without the need for medications or insulin
injections.
If your C-Peptide test reveals significant
destruction of your pancreatic beta cells
it's unlikely
that you'll be able to achieve non-diabetic
blood glucose values without the use of exogenous
insulin, regardless of how strict you are
with your diet and exercise regimen.
If you've been diagnosed with type 2 diabetes
on the assumption that you're insulin resistant,
even though your C-Peptide value was never
tested, then taking a C-Peptide test can help
you
avoid unnecessary oral diabetic medications
and years of unnecessary side effects.
Question #4: What Are Your Chances of Reversing
Prediabetes or
Type 2 Diabetes Without the Need for Diabetes
Medications?
Using conventional treatment, type 2 diabetes
is a progressive disease in which approximately
50% of the individuals require insulin therapy,
within 10 years of diagnosis.
This results from
insulin resistance, the deterioration of beta
cells function, and reduced insulin secretion
over
time.
Using a low-fat, plant-based, whole-food diet
combined with adequate physical exercise
you can reverse prediabetes and type 2 diabetes
in 99% of cases, when there's still sufficient
insulin production.
In this case, your body is producing plenty
of insulin, but your lifestyle has created
a state of
insulin resistance.
By optimizing your diet and moving patterns,
you can reverse insulin
resistance and control blood glucose without
diabetes medication.
A high C-Peptide value indicates that your
beta cells are capable of manufacturing sufficient
insulin, and by switching to a low-fat, plant-based,
whole-food diet it's possible to completely
reverse insulin resistance and eliminate your
need for diabetes medications using your food
as
medicine.
A medium C-Peptide value indicates that you
have adequate insulin production to fully
reverse
prediabetes or type 2 diabetes, but that it's
imperative to maximize your insulin sensitivity
in
order to prevent your beta cells to become
exhausted over time.
A low C-Peptide test means that your beta
cells have been permanently impaired.
In this
situation, you will likely require exogenous
insulin to control your blood glucose.
If you're living with type 2 diabetes and
have been told to inject insulin unaware of
your C-
Peptide value, then you're on the same situation
as millions of people around the world.
The
vast majority of this patients have a medium
or high C-Peptide value and can fully reverse
insulin resistance using lifestyle medicine.
However, while it's true that type 2 diabetes
can often be fully reversed this is not always
the
case.
In the progression towards type 2 diabetes,
beta cells in your pancreas can begin hyper-
secreting insulin as early as 20 years before
diabetes is even detected.
This is done in an effort
to prevent your blood glucose from elevating
as a result of increasing insulin resistance.
Insulin is not the limiting factor in early
stages of the disease process.
As insulin resistance
progresses, beta cells increase insulin production,
sometimes about as much as 500% of
normal, in order to protect against elevated
blood glucose.
Over time, if insulin resistance continues
to develop due to high-fat feeding, the beta
cells in
your pancreas become overworked, resulting
in beta cells death.
When this happens, you
develop a state of impaired insulin production
resulting in high blood glucose in the fasting
and
post-meal states.
Your C-Peptide values follow the same progression
as insulin.
When you're producing excess
insulin, your C-Peptide value increases accordingly,
and when beta cells permanently lose their
ability to produce sufficient insulin, your
C-Peptide value falls significantly.
As long as you're not living with an autoimmune
form of diabetes, there is strong scientific
evidence showing that lifestyle change can
restore beta cells function.
However, optimal
function may never be completely restored.
By testing your C-Peptide level, you and your
doctor can find out how much your beta cells
are
capable of secreting insulin, or if they have
been permanently impaired.
Question #5: What is the Difference Between
a Fasting and Stimulated
C-Peptide Test?
There are two types of C-peptide tests:
* The first is a fasting C-peptide test, performed
after an overnight fast of at least 8 hours.
* The second is a stimulated C-peptide test,
used to measure the amount of insulin your
pancreas is capable of manufacturing in response
to a high-carbohydrate meal
The purpose of the stimulated C-peptide test
is to measure how much insulin your pancreas
produced in the few hour after a carbohydrate
challenge.
The amount of C-Peptide in your blood
reveals how effective your pancreas is at
secreting insulin and C-Peptide in response
to rising
blood glucose.
Reference ranges for the stimulated C-Peptide
are very simple:
* Less than 2 ng/mL means indicates severe
damage to the pancreas with a 5% chance
of controlling blood glucose through lifestyle
measures alone; insulin injections in this
situation are likely required.
* If your stimulated C-peptide test is between
2 - 4 ng/mL then that indicates some
damage to the pancreas with a 50% chance of
controlling blood glucose without insulin.
* If your fasting C-peptide value is greater
than 4 ng/mL this indicates that the pancreas
is
still functioning well with a 95% chance of
controlling blood glucose through lifestyle
measures alone.
Here at Mastering Diabetes, we believe that
a doctor can be your greatest ally in restoring
your
health.
For this reason, we educate our clients on
how they can partner with their doctor to
maximize their metabolic health.
Despite the advancements that have been made
in understanding and treating diabetes over
the past century, lifestyle change education
for physicians is often lacking in medical
school.
Because of this, physicians are unaware of
the power of lifestyle change, and are rarely
educated about the importance of a C-peptide
test for their patients.
In addition, much of
medical school education (as well as post-graduate
continuing education) is funded by
pharmaceutical companies.
These companies have a vested interest in
ensuring that type 2
diabetes patients remain unaware that their
condition is preventable and reversible with
a low-
fat, plant-based, whole-food diet.
Always remember one thing, physicians are
NOT to blame for a lack of education
about lifestyle change.
Until the medical system begins to place a
larger
emphasis on evidence-based approaches to reversing
diabetes, physicians will
continue to remain in the dark.
t's very easy to get your C-Peptide tested.
It's an inexpensive blood test that you can
request
from your doctor, or you can order the test
for yourself online and schedule to have your
blood
drawn at a local LabCorp or Quest Diagnostics
walk-in facility.
You can usually schedule your blood draw for
the same day you place your order and there's
little to no wait time.
Most facilities are open on weekends, so paying
out of pocket is often more
convenient than waiting to see your primary
care physician or endocrinologist.
If you're going to use the latter method,
we suggest ordering from one of the following
online
laboratories:
* Option number 1: RequestATest
* Option number 2: DirectLabs
* Option number 3: PersonalLabs
Simply select where would you like to get
your blood drawn, enter your credit card information
and then take the order form to your local
facility.
The results are quick and often ready in 1
to 3
days.
Now, we recommend using the following guidelines
to interpret your C-peptide test results.
As
you can see, your C-Peptide results are best
interpreted in conjunction with an islet antibody
test - interpreting the results of both tests
together provides the most accurate information.
If your fasting C-Peptide is less than 1.0
ng/mL:
That means your endogenous insulin production
is very low, which means that you fall into
one
of the 3 categories below:
* Number 1: If you test negative for islet
antibodies, then you are likely living with
insulin-dependent type 2 diabetes, with low
insulin production.
You are likely to require
both basal and bolus insulin in order to control
your blood glucose
* If you test positive for one islet antibody
(and are over the age of 30), then you are
likely living with type 1.5 diabetes, and
may require both basal and bolus insulin to
control your blood glucose
* If you test positive for multiple islet
antibodies (irrespective of how old you are),
then
you are likely living with type 1 diabetes,
and may require both basal and bolus insulin
to
control your blood glucose
If your fasting C-Peptide is between 1.0 - 2.0
ng/mL:
That means your endogenous insulin production
is medium, which means that you fall into
one
of the following 3 categories:
* Number 1: If you test negative for islet
antibodies, then you are likely living with
type
2 diabetes (impaired insulin production).
Adopting a low-fat, plant-based, whole-food
diet
to maximize your insulin sensitivity is your
best chance at remaining free of exogenous
insulin
* If you test positive for one islet antibody
(and are over the age of 30), then you are
likely living with type 1.5 diabetes, and
may experience a decline in your insulin
production with an increased need for exogenous
basal and bolus insulin over time
* If you test positive for multiple islet
antibodies (irrespective of how old you are),
you
are likely living with type 1 diabetes and
are currently in the "honeymoon" phase in
which
your endogenous insulin production is declining
quickly.
You will likely experience an
increased need for exogenous basal and bolus
insulin over time
If your fasting C-Peptide is 2.0 ng/mL or
above:
Your endogenous insulin production is medium-to-high,
which means that you fall into one of
the following 3 categories:
* Number 1: If you test negative for islet
antibodies, then you are likely living with
type
2 diabetes (high insulin production).
You are likely to remain free of exogenous
insulin as
long as you continually improve your insulin
sensitivity
* If you test positive for one islet antibody
(and are over the age of 30), then you are
likely living with type 1.5 diabetes, and
may experience a decline in your insulin
production with an increased need for exogenous
basal and bolus insulin over time even
though your endogenous insulin production
is sufficient at this point in time
* If you test positive for multiple islet
antibodies (irrespective of how old you are),
then
you are likely living with type 1 diabetes
and are currently in the "honeymoon" phase
in
which your endogenous insulin production is
declining quickly, even though your
endogenous insulin production is sufficient
now.
You will likely experience an increased
need for exogenous basal and bolus insulin
over time
So there you have it.
Everything you ever wanted to know about your
C-Peptide value, if you
enjoyed this video click on thumbs-up button,
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about your C-Peptide value.
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to help in any way that we can.
C-Peptide – The Most Important Blood Test for Diabetes https://www.youtube.com/watch?v=iDyj76_lOBY C-peptide is an important indicator of your diabetes health and one of the most important of all diabetes biomarkers. A C peptide test can help tell you: -What type of diabetes are you actually living with? -Are you living with autoimmune diabetes (type 1 diabetes or type 1.5 diabetes)? -How much damage have your beta cells accumulated over time? -What are your chances of reversing prediabetes or type 2 diabetes without the need for exogenous insulin? -Can you fully reverse prediabetes or type 2 diabetes? Make sure not to miss a our future videos! Click here to Subscribe: http://www.youtube.com/user/mindfuldiabeticrobby ?sub_confirmation=1 Mastering Diabetes Cyrus Khambatta, PhD Robby Barbaro Diabetes Nutrition and Fitness Coaches Here are other related videos: Diabetes Diet — How Heather Dropped Her A1c from 9.2% to 5.2% https://www.youtube.com/watch?v=x-KIl6OaqM0 Reversing Type 2 Diabetes — Tami's A1c Improved from 7.1% to 5.3% — The Mastering Diabetes Program https://www.youtube.com/watch?v=epfKVih_Vsk Reverse Type 2 Diabetes — How Tina Dropped Her A1c from 10.6% to 5.4% in 90 Days https://www.youtube.com/watch?v=g4_23aM29t8 C-peptide could be the game changer you are looking for. Knowing your c-peptide level could be the difference between full control of your diabetes health and being at a loss. It will also help people living with type 2 diabetes set realistic expectations. Seeing you have a high c peptide level can be very motivating! #cpeptide #insulinresistance #masteringdiabetes
