Correlation of fasting C-peptide levels with abdominal adipose tissue thickness and pancreatic size amongst poorly controlled diabetic elderly patients

Background

Insulin resistance (IR) and diabetes are common chronic conditions amongst elderly patients, that may lead to increase in abdominal adipose tissue deposits and pancreatic size.

Methods

A cross-sectional study was conducted in the geriatric OPD in a tertiary care hospital for a period of six months to correlate fasting C-peptide levels, abdominal adipose tissue thickness, and pancreatic size in poorly controlled diabetic elderly patients. Diabetic elderly patients with HBA1c level >7 % were enrolled with their consent. Body mass index (BMI), fasting C-peptide, abdominal adipose tissue thickness and pancreatic size were measured using standard laboratory techniques. The data obtained were assessed categorically and represented as [n (%)]. T-test was used to compare the two groups (p < 0.05).

Results

A total of 101 patients were enrolled. The study results showed no significant correlation between subcutaneous fat and pre-peritoneal fat thickness; and fasting c-peptide levels (p = 0.801, p = 0.316). However, there was a significant correlation between the fasting c-peptide levels and pancreatic size (p = 0.001). It was also observed the study participants had a decreased pancreatic size, with the mean size being 4.837 cm in males, and 4.4418 cm in females.

Conclusion

Intra-peritoneal fat thickness and pancreatic size can be used as surrogate marker for IR along with C-peptide. All elderly with uncontrolled type 2 diabetes mellitus behaving like type 1 diabetes mellitus needs further evaluation and pathogenic process must be explored. Sarcopenic obesity evaluation must be a part of uncontrolled type diabetes mellitus management.