Insulin is a peptide hormone secreted by the β cells of the pancreatic islets of Langerhans and maintains normal blood glucose levels by facilitating cellular glucose uptake, regulating carbohydrate, lipid and protein metabolism and promoting cell division and growth through its mitogenic effects. C-peptide is a byproduct created when insulin is produced. Both insulin and C-peptide are created from a larger molecule called proinsulin which undergoes enzymatic cleavage to become des-31,32-proinsulin and des-64,65-proinsulin and eventually, insulin and C-peptide (an inactive peptide chain).
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Disorders most common to insulin and c-peptide dysregulation include diabetes, insulinomas (a tumor of the pancreas that causes excess insulin to be produced), hypokalaemia, Cushing’s syndrome, and kidney disease. The measurement of plasma insulin, C-peptide and proinsulin concentrations have been identified as the most useful test in identifying causes of hyperglycemia (high blood glucose) such as Type 1 and Type 2 diabetes which are chronic metabolic diseases due either to a lack of insulin secretion or reduced insulin sensitivity. Overall, raised levels indicate endogenous hyperinsulinaemia, which is often seen in people with early-stage type 2 diabetes mellitus, and low levels indicate type 1 diabetes.
Early assays for insulin, proinsulin, and C-peptide were competitive RIAs, however, most commercial assays are now competitive (Insulin and C-peptide) or two-site enzyme immunoassays (total or intact proinsulin).
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