Serum C-peptide assay of patients with hyperglycemic emergencies at the Lagos State University Teaching Hospital (LASUTH), Ikeja (International Archives of Medicine)

Title: Serum C-peptide assay of patients with hyperglycemic emergencies (HE) at the Lagos State University Teaching Hospital (LASUTH), Ikeja Lagos State, South West Nigeria.IntroductionHE are common acute complications of diabetes mellitus (DM) and include diabetic ketoacidosis (DKA), normo-osmolar hyperglycemic state (NHS) and hyperosmolar hyperglycemic state (HHS). They contribute a lot to the mortality and morbidity of DM. The clinical features include dehydration, hyperglycemia, altered mental status and ketosis. The basic mechanism of HE is a reduction in the net effective action of circulating insulin, resulting in hyperglycemia and ketonemia (in DKA) causing osmotic diuresis and electrolytes loss. Infection is a common precipitating factor.Measurement of serum C-peptide provides an accurate assessment of residual beta-cell function and is a marker of insulin secretion in DM patients.Aim and objectives: To assess the level of pancreatic beta cell function in HE patients, using the serum C-peptide.Methodology: The biodata and clinical characteristics of the 99 subjects were collated using a questionnaire. All subjects had their serum C-peptide, glucose, electrolytes, urea, creatinine levels, urine ketones determined at admission. Results of statistical analysis were expressed as mean +/- standard deviation (SD). A p value 0.05).Main precipitating factors were poor drug compliance, new-onset of DM and infection. Conclusion: Most (70%) of subjects had poor pancreatic beta cell function, this may be a contributory factor to developing HE. Most subjects with high C-peptide levels had HHS.