An Observational Comparative Study of the Effect of Sepsis on Serum CPeptide and Insulin Levels in Patients with Type 2 Diabetes Mellitus

Introduction: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and a relative deficiency in insulin secretion. Patients with T2DM are more susceptible to infections and sepsis due to the immunocompromised state associated with chronic hyperglycemia. The interplay between C-peptide, insulin, and HbA1c levels during sepsis requires careful monitoring and management to optimize glycaemic control and improve patient outcomes. Understanding these dynamics is crucial for effectively managing T2DM patient. Aim: To assess serum c-peptide and insulin levels in type 2 diabetes with or without sepsis. Material and Methods: This observational comparative study, conducted at SMS Medical College, Jaipur, included 180 participants divided into three groups: diabetic patients with sepsis (Group A), diabetic patients without sepsis (Group B), and non-diabetic patients with sepsis (Group C). Each group underwent clinical evaluation and laboratory investigations, including C-peptide, insulin levels, CBC, and SOFA score, with sepsis diagnosed using Sepsis-3 criteria. Data were analyzed to compare organ dysfunction and inflammatory responses across groups. Results: Our study shows that sepsis elevates both C-peptide and insulin levels, with a more pronounced increase in C-peptide, particularly in diabetic patients, reflecting its immune-modulating role. Additionally, sepsis significantly impacts platelet counts, GCS scores, SOFA scores, albumin levels, and TLC, emphasizing its systemic effects. Conclusion: Our findings demonstrate that sepsis enhances pancreatic activity, as shown by increased C peptide and insulin levels, but this response is influenced by the presence of diabetes. Thus, C peptide serves as a valuable marker for assessing pancreatic function in the context of sepsis, highlighting the complex interplay between diabetes and sepsis on pancreatic and insulin dynamics.