Evaluating the role of spot urine C-peptide creatinine ratio (UCPCR) in the diagnosis and management of diabetes in children and young adults

The mixed meal tolerance test (MMTT) is the gold standard measure of endogenous insulin secretion in Type 1 diabetes (T1 D), but practical issues limit its use in clinical practice. Urine C-peptide creatinine ratio (UCPCR) had recently been demonstrated to be stable for 3 days at room temperature using boric acid as a preservative. In this thesis I present work on the validation and utility of urinary C- peptide measurement in children and young adults with diabetes. Chapter 1 assesses the ability of UCPCR to be used instead of a MMTT stimulated serum C-peptide in 72 patients with T1 D. Ninety minute MMTT stimulated serum C-peptide (90CP) was highly correlated to 120 minute UCPCR taken during a MMTT (rs=0.97, p2 years to discriminate non-T1D (MODY and T2D) from T1 0 (100% sensitivity/ 97% specificity). An overview of the major findings of each chapter, the clinical implications and areas of future research are discussed in Chapter 6.EThOS - Electronic Theses Online ServiceGBUnited Kingdo