Clinical Influence of the C-peptide/Blood Glucose Ratio on Newly Diagnosed Type 2 Diabetic Ketosis

Chen Xiaoluo; Wang Li; Zhang Yan

doi:10.3969/j.issn.1004-5775.2025.18.009

Abstract：Objective:To investigate the relationship between C peptide to glucose ratio(CPI)and ketosis in patients with newly diagnosed type 2 diabetes mellitus,and to analyze the clinical characteristics of ketosis in patients with newly diagnosed type 2 diabetes mellitus for the first time,so as to provide reference for the early intervention and treatment of ketosis in the clinic.Methods:From January to December 2020,56 patients with newly diagnosed type 2 diabetes mellitus complicated with ketosis were selected,and 67 patients with newly diagnosed type 2 diabetes mellitus with non-ketosis were selected during the same period,and they were divided into observation group and control group.The effects of body mass index(BMI),fasting C-peptide/fasting blood glucose ratio(FCPI),glycosylated hemoglobin(HbA1c),age and other factors on urine ketones were observed.After short-term intensive hypoglycemic reduction with insulin pump,the levels of Δ fasting C-peptide/fasting blood glucose(ΔFCPI)and Δ 2h postprandial C-peptide/2-hour postprandial blood glucose(ΔPCPI)were calculated,and the effect of CPI on urine ketones was analyzed.Results:Urinary ketone bodies were negatively correlated with age(r=-0.438),fasting C-peptide(r=-0.305),and FCPI(r=-0.414),and positively correlated with HBA1C(r=0.301),fasting blood glucose(r=0.374),and eGFR(r=0.231).After intensive treatment,it was negatively correlated with Δ 2-hour postprandial C-peptide(r=-0.277)and ΔPCPI(r=-0.276).The results of logistic regression analysis showed that age,FCPI at the initial diagnosis and ΔPCPI after intensive treatment were risk factors for ketosis in newly diagnosed T2DM(OR=0.913,0.883,0.387).Conclusion:Younger age at onset and the low C-peptide/glucose ratio will increase the risk of newly diagnosed type 2 diabetic ketosis.It is necessary to strengthen the education of young diabetic patients,and pay attention to the early screening of pancreatic islet function in clinical work.