What are the risks of a high C-peptide level at the two-hour mark?

Elevated C-peptide levels at the two-hour mark indicate that pancreatic beta cells are working under excessive strain, which may lead to conditions such as hypoglycemia, diabetes, or insulinoma.

1. Hypoglycemia

If a patient develops hypoglycemia and C-peptide levels exceed the normal range, excessive insulin secretion should be considered. Clinically, this mainly presents as post-fasting or post-exercise hypoglycemia. During episodes, blood glucose drops below 2.8 mmol/L, with significantly elevated plasma insulin and C-peptide levels. A minority of patients may develop gastrointestinal ulcers. Treatment under medical guidance may include corticosteroids such as methylprednisolone tablets or cortisone acetate tablets.

2. Insulinoma (Pancreatic Beta Cell Tumor)

This is an adenoma or tumor arising from pancreatic beta cells that excessively secretes insulin. The insulin secretion cannot be suppressed by low blood glucose, resulting in hypoglycemia. Surgical removal is usually required.

3. Diabetes

Diabetes can have numerous negative effects on the body and commonly presents as weight loss, sweating, dizziness, irritability, drowsiness, and other symptoms, requiring timely treatment. Dietary management should focus on controlling total caloric intake, with low salt, low fat, low sugar, and high fiber content. Under a doctor's supervision, oral hypoglycemic agents such as metformin dispersible tablets, acarbose tablets, or insulin therapy may also be used.

In addition to the above conditions, elevated C-peptide levels may also reflect insulin resistance.