Imperial Collage Healthcare


Test Background
Pro-insulin is cleaved to form connecting peptide (C-peptide) and insulin prior to secretion into the portal circulation. They are secreted in equi-molar concentrations, however C-peptide is metabolised more slowly than insulin. C-peptide can be helpful in the differential diagnosis of type 1 and 2 diabetes mellitus. The insulin:C-peptide ratio can be used to diagnose use of exogenous insulin.

Clinical Indications

  • Evaluation of fasting hypoglycaemia: β-cell tumours or factitious causes, eg. abuse of sulphonylureas, exogenous insulin
  • Classification of diabetes mellitus: in type 1, C-peptide is normal/raised while, in type 2, C-peptide is decreased
  • Diagnosis of insulinoma
  • Monitoring purposes (following pancreatectomy or pancreal/islet cell transplant)

Reference Range

C-peptide (pmol/L) ratio to insulin (mIU/L) : 30-70

Sample Required
Serum (red top) on ice rush to laboratory

Sample Volume
1 mL

Turnaround Time
1 week

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