Evaluation of C-peptide in Type 2 Diabetic Patients in Douala Cameroon: C-peptide Correlation with Arterial Hypertension and the Types of Treatment Administered

Abstract

Introduction: C-peptide is the best indicator of endogenous insulin secretion; it makes it possible to optimize the treatment, and to prevent the occurrence and the evolution of the damages resulting from type 2 diabetes. The present study reports the variation of C-peptide levels according to the types of treatment administrated and the high blood pressure in type 2 diabetes in two hospitals (General Hospital and Gyneco-Obstetric and Pediatric Hospital) in the city of Douala Cameroon. Methodology Over a period of 9 months (from October, 1st 2017 to June, 30th 2018), we conducted an analytical cross-sectional study involving subjects with type 2 diabetes regularly monitored at the General Hospital and Gyneco-Obstetric and Pediatric Hospital of Douala Cameroon. Inclusion criteria we included any subject whose diagnosis of type 2 diabetes was mentioned in the medical file. The fasting C-peptide assays were performed according to the principle of electrochemiluminescence. The ANOVA and PEARSON tests were use to investigate on the one hand the correlations between the C peptide levels and the types of treatment administered, and on the other hand between the C-peptide levels and arterial hypertension. The significant threshold was set at P <0.05. Results: Our population, made up of 90 subjects, had a mean age of 58±12.31 years, sex ratio 0.8 in favor of women. The mean duration of diabetes was 8.71±6, 94 years, we had 30 hypertensive subjects under hypertensive treatment, the mean C-peptide levels was 2.50±1.68ng / ml. We found that C-peptide levels increased with patient ages (P=0.004), a significant correlation between C-peptide levels and high blood pressure (P=0.022), and C-Peptide levels varied significantly depending on the type of treatment (P=0.04). Conclusion: Type 2 diabetic patients on oral antidiabetic drugs, and having a low level of C-peptide, should undergo a modification of their treatment by the addition (or the replacement) of insulin, for better glycemic control. Diabetic and hypertensive patients are more exposed to micro and macrovascular complications. Hence the importance of instituting more assiduous blood pressure control, appropriate hypotensive therapy, as well as training patients in self-management and prevention of the onset of complications related to diabetes.