Assessing Endogenous Insulin Production with Urinary C-peptide to Creatinine Ratio

Clinical Implications and Guidelines

• The American Diabetes Association notes that differentiation between type 1 and type 2 diabetes can usually be made based on clinical presentation and subsequent course, but C-peptide measurement can be helpful in ambiguous cases 1, 2
• Routine testing for insulin or C-peptide is not recommended for most people with diabetes according to current guidelines from the American Diabetes Association 1, 3
• C-peptide measurements, such as UCPCR, should be reserved for cases where differentiation between diabetes types is unclear, such as individuals with type 2 phenotype who present in ketoacidosis 1, 3