Comparing C-peptide and HbA1c levels in obese patients with and without type 2 diabetes

Authors

  • N. Sridevi Government Medical College, Vijaywada, Andhra Pradesh, India
  • N. Chowdeswari Government Medical College, Vijaywada, Andhra Pradesh, India
  • A. Navaneeta Lakshmi Government Medical College, Vijaywada, Andhra Pradesh, India
  • P. Madhusudhan Government Medical College, Vijaywada, Andhra Pradesh, India
  • N. Kirmani Government Medical College, Vijaywada, Andhra Pradesh, India
  • Rakesh Anil Government Medical College, Vijaywada, Andhra Pradesh, India
  • Shyam Sundar Kumar Government Medical College, Vijaywada, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20262631

Keywords:

Obesity, HbA1c, C-Peptide, Diabetics, Non-diabetics, Insulin resistance

Abstract

Background: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by either insufficient insulin production by the pancreas or the body's inability to utilize it. HbA1c level of 6.5% was recommended for diagnosing diabetes. C-peptide is a byproduct of insulin synthesis has been widely studied as a diagnostic biomarker for DM. Obesity is a major risk factor for the development of type 2 DM (T2DM) and is associated with insulin resistance. With the increasing global burden of obesity and diabetes, our study investigates the relationship between HbA1c and C-peptide levels in obese individuals with and without diabetes. Objectives were to assess and compare HbA1c and C-peptide levels among obese individuals with diabetes and without diabetes and to evaluate the correlation between these parameters within each group.

Methods: This study was included 30 obese diabetic and 30 obese non-diabetic participants recruited over 3 months. Blood samples were collected for estimating HbA1c and C-peptide. Ethical approval was obtained prior to the study. Data were analyzed using Jamovi software.

Results: HbA1c and C-peptide levels were significantly higher in obese individuals with diabetes compared to non-diabetic obese controls (p<0.001). A strong positive correlation was observed between HbA1c and C-peptide levels in both groups, with a stronger association in diabetics (r=0.94) compared to non-diabetics (r=0.88); both correlations were statistically significant.

Conclusions: Higher levels and strong positive correlation between HbA1c and C-peptide-especially in diabetics-suggests increased insulin secretion in response to poor glycemic control and insulin resistance.

 

References

World Health Organization. Diabetes. Geneva: World Health Organization; 2024 Nov 14. Available at: https://www.who.int/news-room/fact-sheets/detail/diabetes. Accessed on 22 April 2026.

Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2021. Results. Institute for Health Metrics and Evaluation. 2024. Available at: https://vizhub.healthdata.org/gbd-results/. Accessed on 22 April 2026.

World Health Organization. WHO/NMH/CHP/CPM/11.1. Geneva: World Health Organization; 2011. Available at: https://apps.who.int/iris/handle/10665/44579. Accessed on 22 April 2026.

Nathan DM, Turgeon H, Regan S. Relationship between glycated haemoglobin levels and mean glucose levels over time. Diabetologia. 2007;50:2239-44.

International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1327-34.

Forst T, Kunt T, Pfützner A, Beyer J, Wahren J. New aspects on biological activity of C-peptide in IDDM patients. Exp Clin Endocrinol Diabetes. 1998;106(4):270-6.

Cardellini M, Farcomeni A, Ballanti M. C-peptide: A predictor of cardiovascular mortality in subjects with established atherosclerotic disease. Diab Vasc Dis Res. 2017;14(5):395-9.

Becht FS, Walther K, Martin E, Nauck MA. Fasting C-peptide and related parameters characterizing insulin secretory capacity for correctly classifying diabetes type and for predicting insulin requirement in patients with type 2 diabetes. Exp Clin Endocrinol Diabetes. 2016;124(3):148-56.

Cabrera de León A, Oliva García JG, Marcelino Rodríguez I. C-peptide as a risk factor of coronary artery disease in the general population. Diab Vasc Dis Res. 2015;12(3):199-207.

Williams GV, Gambhir KK, Nunlee-Bland G, Abrams CK, Ganta V, Odonkor W. Significance of plasma C-peptide in obese African American adolescents. J Natl Med Assoc. 2011;103(10):907-16.

Gonzalez-Mejia ME, Porchia LM, Torres-Rasgado E, Ruiz-Vivanco G, Pulido-Pérez P, Báez-Duarte BG, et al. C-peptide is a sensitive indicator for the diagnosis of metabolic syndrome in subjects from Central Mexico. Metab Syndr Relat Disord. 2016;14(5):210-6.

Weir CB, Jan A. BMI classification percentile and cut off points. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2020.

Bluher M. Adipose tissue dysfunction in obesity. Exp Clin Endocrinol Diabetes. 2009; 117(6):241-50.

World Health Organization. Obesity and overweight. Geneva: WHO; 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.

Esze R, Barna S, Fülöp P, Czakó M, Varga T, Mészáros Á, et al. C-peptide: an essential ally in microvascular complications of type 2 diabetes mellitus and obesity. Diabetol Metab Syndr. 2024;16:211.

Khan HA, Sobki SH, Ekhzaimy A, Khan I, Almusawi MA. Biomarker potential of C-peptide for screening of insulin resistance in diabetic and non-diabetic individuals. Saudi J Biol Sci. 2018;25(8):1729-32.

Anoop S, Misra A, Bhatt SP, Gulati S, Mahajan H. High fasting C-peptide levels and insulin resistance in non-lean and non-obese (BMI >19 to <25 kg/m²) Asian Indians with type 2 diabetes are independently associated with high intra-abdominal fat and liver span. Diabetes Metab Syndr. 2019;13(1):708-15.

Chowta MN, Adhikari PM, Chowta NK, Shenoy AK, D'Souza S. Serum C peptide level and renal function in diabetes mellitus. Indian J Nephrol. 2010;20(1):25-8.

Saisho Y, Kou K, Tanaka K, Abe T, Shimada A, Kawai T, et al. Association between β cell function and future glycemic control in patients with type 2 diabetes. Endocr. J. 2013;60:517-23.

Ismail HM, Evans-Molina C, DiMeglio LA, Becker DJ, Libman I, Sims EK, et al. Associations of HbA1c with the timing of C-peptide responses during the oral glucose tolerance test at the diagnosis of type 1 diabetes. Pediatr Diabetes. 2019;20(4):408-13.

Miya A, Nakamura A, Nomoto H, Kameda H, Atsumi T. Positive association between the proinsulin-to-C-peptide ratio and prolonged hyperglycemic time in type 2 diabetes. Endocr J. 2024;71(4):403-8.

Banu S, Jabir NR, Manjunath CN, Shakil S, Kamal MA. C-peptide and its correlation to parameters of insulin resistance in the metabolic syndrome. CNS Neurol Disord Drug Targets. 2011;10(8):921-7.

Aruna V. Correlation of c-peptide and HbA1c in type ii diabetes mellitus. Int J Res Rev. 2021;8(6):297-303.

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Published

2026-07-30

How to Cite

Sridevi, N., Chowdeswari, N., Navaneeta Lakshmi, A., Madhusudhan, P., Kirmani, N., Anil, R., & Kumar, S. S. (2026). Comparing C-peptide and HbA1c levels in obese patients with and without type 2 diabetes. International Journal of Research in Medical Sciences, 14(8), 3423–3427. https://doi.org/10.18203/2320-6012.ijrms20262631

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Original Research Articles