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Evaluation of urinary C-peptide as a non-invasive biomarker for the diagnosis of type 2 diabetes mellitus at Kenyatta National Hospital, Kenya
Abstract
Diabetes mellitus, a noncommunicable disease affecting over 589 million people worldwide, and nearly 50% remain undiagnosed. It is characterized by hyperglycemia caused by insulin abnormalities or inadequacies, leading to various health issues due to macrovascular and microvascular alterations. Early diagnosis of diabetes is essential for effective disease management, and innovative non-invasive biomarkers are needed to overcome and address the challenges posed by traditional blood-based tests. Developing non-invasive biomarkers is a critical step for enhancing patient compliance with diabetes screening. The C-peptide hormone, which mirrors endogenous insulin secretion and is excreted in the urine, represents a promising noninvasive candidate. This study aimed to evaluate the correlation between urinary C-peptide levels and conventional glycemic control parameters in newly diagnosed patients with type 2 diabetes mellitus (T2DM) in the Kenyan population. A cross-sectional study was conducted among 54 newly diagnosed patients with type 2 diabetes mellitus attending Kenyatta National Hospital. The urinary C-peptide levels were quantified from first-morning urine specimens using a chemiluminescent immunoassay principle. Glycated hemoglobin levels were determined using a chemiluminescent microparticle immunoassay technology, while fasting blood sugars were determined with the use of a glucometer. Pearson's correlation coefficient was used to assess the relationships between variables. A significantly strong positive correlation was observed between fasting blood sugar and glycated hemoglobin (r = 0.607, p <0.001). In contrast, urinary C-peptide concentrations showed comparatively weak, statistically insignificant relationships with fasting blood sugar (r = 0.132, p = 0.342) and glycated hemoglobin (r = 0.225, p = 0.102). The weak correlations observed with glycemic control indicators suggest limited utility of urinary C-peptide as a standalone noninvasive diagnostic tool for type 2 diabetes mellitus. Nevertheless, its noninvasive nature and metabolic stability suggest that it has potential for further investigation in more extensive and extended studies, particularly for assessing endogenous insulin secretion. Based on these data, we recommend that urine C-peptide serve as a supplemental biomarker rather than an alternative to standard glycemic diagnosis, particularly for evaluating beta-cell activity and insulin secretion dynamics in patients with diabetes. Additionally, we propose an investigation into the potential of the urine C-peptide hormone for monitoring therapy efficacy.
