C-peptide: from diagnosis to clinical application

C-peptide is a linker between the A- and the B- chains of insulin and, following enzymatic breakdown, is released into the circulation

as a 31-amino acid chain in an equimolar amount with insulin. Serum C-peptide level in the plasma is independent of the administration

of exogenous insulin and does not interfere with autoantibodies that are formed against it; therefore, for diagnostic purposes, its

determination is much more reliable and accurate than that of insulin. Originally used only in diagnosing, C-peptide is currently known

for its endogenous effects. C-peptide may affect the degree and extent of vascular and nervous complications, its higher level prevents

endothelial dysfunction and it also has analgesic effects. These direct and indirect effects give rise to considerations about possible

therapeutic use. In the year 2010, authorities in the field of diabetes published new recommendations for the diagnosis and screening

that reflect the global pandemic of this disease, including the incidence of morbidity, enforced disability and mortality. The review also

presents the possibilities of C-peptide utilization.

Keywords: C-peptide, insulin, diagnosis, endogenous effects, screening