I had a c-peptide test done 2 weeks ago. When I met with my endo, he just said it was “low.” I took that to mean “not enough to worth talking about,” since he didn’t talk about it at all. I was at my primary care physician’s office today, and she printed out the results for me. The # was 0.9 for c-peptide, just slightly below the threshold for “normal,” which is between 4.4 and 1.1. I had assumed my honeymoon period was over since I have a higher insulin to carb ratio than my brother, who has had t1 for 13 years. However, my first (uneducated) reaction to this # is that I’m only producing slightly less insulin than a non-diabetic, and that I can expect this # to continue to fall, and my insulin usage to go up and up.
Can someone here explain what this # actually means in terms of my honeymoon period and insulin management? Should I expect to gradually have increased BG and need to increase my basal and bolus doses?
C-peptide is a measurement of how much insulin your pancreas is actually producing. It is helpful to know what your c-peptide was when you were diagnosed to see how much it has changed. Like everything else, everyone is different so we really can’t estimate how long of a honeymoon period you will have. I have heard of up to 2 years and mine was one very short month. During the honeymoon period, insulin production may be unpredictable and sporatic in nature. You may need a little more insulin but maybe not as things even out even though the beta cells die completely. and about the time you get things figured out they will change anyway. At least that seems to be my experience. But hey, we have the rest of our lives to figure this disease out…but that could change too if someone really does find a cure.
Hi Donna, thanks for the response.
This was my first c-peptide test. I was expecting it to be close to 0, and was surprised to see it just slightly below the normal threshold. I don’t have a comparison #, so I can’t really tell how fast it’s falling. I guess I’m just trying to gauge how little insulin production I actually have left, how long I’ll have it for, and how much my insulin requirements might go up once it finally hits 0 (assuming it will hit 0, which I guess isn’t guaranteed, right?)
Afraid there are no answers to your questions. No one can tell you how long your current insulin production will last or how fast it will decline. As Donna said, insulin output will be intermittent, which makes dosing difficult during the honeymoon phase. Keeping BG as level as possible without major spikes is the best thing you can do to preserve your remaining beta cells.
My honeymoon phase lasted about two months.
Hi Dan: Endocrinologist Bruce Buckingham MD at Stanford is doing clinical trials where he takes a newly diagnosed Type 1 and begins REALLY intensive insulin therapy at the start. He has had huge success in beta cell preservation and a goal is to prolong the honeymoon period indefinitely. Bottom line is, if you do tight control, you can make your honeymoon period last for many years and that is really beneficial to your health. You obviously have some remaining insulin production, so I would say do everything you can to preserve it.
My personal experience was that I had a sharp end of my honeymoon at about 1 year. I say go for it and good luck!
I would also note that a fasting insulin level has to be interpreted against the blood sugar of when you had the test taken. If you have fasted and have a low fasting blood sugar, a low c-peptide may tell you very little about your insulin production. On the other hand, having a high fasting blood sugar (> 200 mg/dl) with a below normal c-peptide strongly suggests that you are insulin deficient. If I recall, my c-peptide was measured at one point at 1.3 with a fasting blood sugar of 130 mg/dl and I was told that was “normal.”
Some people believe that you keep “some” level of insulin production forever, that you can “preserve” your beta cells by avoiding high blood sugars (glucotoxicity) and that keeping some level of insulin production can enable you to much more easily maintain good blood sugar control even when you do need insulin.
Thanks for the interesting info. I have been keeping pretty tight control the last 3 weeks or so. In the first two or three weeks on insulin, I could eat the same thing at the same time with the same dosage 3 days in a row, and have post-meal blood sugars anywhere from 60 to 200. All I could do was scratch my head! Maybe all that was due to intermittent beta cell activity.
Things seem to have settled down a lot since then though, and I can guess where my post-meal #s will be within 20 points or so more than half the time. I would like to believe that my body is acclimating to the treatment, and maybe my pancreas knows how much to “chip in” and when. Maybe that’s wishful thinking though.
The # is from a fasting blood test. My BG from the test was 115. I actually woke up with a BG of 93, according to my meter, and finally got in to have my blood drawn about an hour and a half after I woke up. I’m wondering if this is either gross meter error or if my BG actually rose while those evil receptionists at the lab made me sit in the waiting room for forty minutes despite my pleas for them to take me in already!
It could be the meter, but I’ve seen my numbers rise somewhat on my continous glucose monitor from when I first wake up to 40-45 minutes later when I eat breakfast and I’ve seen others posting about a similiar experience. I think it has something to do with certain hormones kicking after you wake up. Though stress at doctor’s office has also cause my numbers to rise too!
When people want to compare the meter’s result with lab tests, they usually check right before getting their blood drawn.