{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:46:33Z","timestamp":1791931593212,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evaluation of residual beta cell function is indispensable in patients with type 2 diabetes as it informs not only diagnoses but also appropriate treatment modalities. However, there is a lack of convenient biomarkers for residual beta cell function. Therefore, we evaluated endogenous insulin level as a biomarker in outpatients who were being treated with insulin therapy and in patients who were introduced to insulin therapy after 4\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data of 174 outpatients with type 2 diabetes (50% male) whose glycemia was moderately controlled (glycated A1c 7.3% [5.2%\u201314.8%]) were reviewed. Twenty patients whose estimated glomerular filtration rate was lower than 30\u2009ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup> were excluded from the evaluation of endogenous insulin level with both casual C\u2010peptide index (C\u2010CPI) and urinary C\u2010peptide\/creatinine ratio (determined at any time, generally 1\u20132\u00a0h after breakfast). Patients were stratified based on the provision of insulin therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>C\u2010CPI and UCPCR were significantly lower in the insulin\u2010treated patients than in the insulin\u2010untreated patients (0.9 vs. 2.2, <jats:italic>p<\/jats:italic> &lt; 0.0001; 24.7 vs. 75.5, <jats:italic>p<\/jats:italic> = 0.0003, respectively). Moreover, C\u2010CPI were significantly lower in the insulin\u2010requiring patients for 4 years than in the insulin\u2010unrequiring patients (1.0 vs. 1.7, <jats:italic>p<\/jats:italic> = 0.0184). The multivariate logistic regression analysis revealed that both indicators of insulin secretion influenced the requirement for insulin therapy, but C\u2010CPI could serve as the most convenient and useful biomarker for not only current insulin therapy requirements (<jats:italic>p<\/jats:italic> = 0.0002) but also the subsequent requirement for insulin therapy (<jats:italic>p<\/jats:italic> = 0.0008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>C\u2010CPI could be determined easily, and it was found to be a more practical marker for outpatients; therefore, our findings would have critical implications for primary care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1753-0407.13257","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T08:18:57Z","timestamp":1646122737000},"page":"221-227","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Casual C peptide index: Predicting the subsequent need for insulin therapy in outpatients with type 2 diabetes under primary care"],"prefix":"10.1111","volume":"14","author":[{"given":"Ryota","family":"Uehara","sequence":"first","affiliation":[{"name":"Department of Medicine and Molecular Science Gunma University Graduate School of Medicine  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0332-8605","authenticated-orcid":false,"given":"Eijiro","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Medicine and Molecular Science Gunma University Graduate School of Medicine  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyo","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Medicine and Molecular Science Gunma University Graduate School of Medicine  Maebashi 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