#466 Defining Diabetes: C-Peptide and Beta Cell

April 14, 2021Scott Benner

Scott and Jenny Smith define diabetes terms

In this Defining Diabetes episode, Scott and Jenny explain C-Peptide and Beta Cell

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Scott Benner 0:00
Friends, you're listening to Episode 466 of the Juicebox Podcast.

Today, you're going to get a two for one defining diabetes. As Jenny Smith and I define beta cells, and C peptide. There's actually some bonus BONUS stuff in this too. For one, it's almost four for one, but I don't want to get confusing so you'll see as it goes. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical, or otherwise, please always consult a physician before making any changes to your health care plan. We're becoming bold with insulin. After you're done listening to the podcast, they head to Omni pod.com Ford slash juice box and take the pod for a test drive. You can ditch your daily injections, or send your pump packing, try the Omni pod tubeless wireless continuous insulin management system. All you have to do is head on the pod comm forward slash juice box and when you get there, you're going to find out if you're eligible for a free 30 day trial of the Omni pod dash. That is crazy. Just get over I mean for free for a whole month. I know you know this, but there are 12 months in a year, you're getting 1/12 of the Year for free. You may be thinking right now Scott is on the pod still offering the free no obligation demo pod at on the pod comm forward slash juicebox? Well, yes they are. So head on over and see what option is right for you. There are also links in the show notes of your podcast player and at Juicebox Podcast comm if you can't remember on the pod comm forward slash juice box. I feel like I say this a lot of these in the beginning of these defining episodes. But I'm just going to come clean and tell you that I hear people say C peptide all the time. And I don't know what it means by the end. But here's my best story. A person who I saw online once who's been alive for just you know, must be 80 years old, said Type One Diabetes their whole life talked about one time how he missed older insulin because of C peptide. And I never understood what he was saying. And I'm wondering if like, was there There used to be an additive and insulin that doesn't exist anymore? Am I confusing two phrases Jenny's face is telling me I'm completely wrong about this?

Jennifer Smith, CDE 2:45
No, it's a really well and this statement in and of itself, you're not necessarily wrong. But

Unknown Speaker 2:52
did they use the Add

Jennifer Smith, CDE 2:54
older insulin, they wouldn't have added c peptide, there's no purpose. So I think the definition of C peptide will give you reason for like the faces that clearly nobody else can see that I'm making to you look absurd.

Scott Benner 3:10
It kind of goes to my confusion about it because no one says these this word out loud ever like I am as involved in people talking about type one diabetes as any person could be. And no one says c peptide. But I think it's important to understand. So that's why I'm going to pick your brain for it. So what is it?

Jennifer Smith, CDE 3:31
So it's easy, it's actually it's a byproduct, essentially of insulin production. So when you're paying kurious, not outside insulin light from your bottle or your vial that you pump in or in Juju inject in pancreatic insulin that is created has a has c peptides, which are really just amino acids. It's like a structure right. And when the insulin is made, think of it as a round ball, for lack of a better visual. And when insulin gets released into the bloodstream, a part of it gets cleaved off from the creation and that part, which looks like a C way it looks better for you. So it's called C peptide c peptide, to my understanding really has no has no purpose offs of the creation of the insulin. Once insulin gets into the bloodstream and is doing its job. C peptide is what's left over sort of like byproduct. And so it floats around and it's a marker of how much insulin is being produced by the beta cells in the body. But outside generically created insulin or lab created insulin does not have C peptide in it, it was not created by the body. So that's why somebody with diabetes even using rapid insulin or Basal insulin or anything, they can still have C peptide levels drawn to see what is their actual beta cell pulled out, if any? Because the injected insulin doesn't have it, so it doesn't make a difference. But does that?

Scott Benner 5:16
No, it does, but it doesn't. So it doesn't do anything. There's no, like C peptide has no function, it's just a measurement we use to say. Okay, so the, the less, I'm assuming the less c peptide that can be found with testing is an indication of less and less insulin being produced by the pancreas.

Jennifer Smith, CDE 5:37
So there, there are markers, you know, certain lab levels that if it's under this level, that's diagnostic diagnostic of type one diabetes, some people get their c peptide levels tested through the course of the years, you know, to see is it declining? Is my C peptide level? Obviously, still type one, but is it kind of like stabilized? Am I not really losing any more betas or whatever? I mean, quite honestly, obviously, we know that once you have type one diabetes, you have type one diabetes, you know, but I think another way to like think about C peptide in terms of like it being a byproduct, it's sort of like when you're burning like wood in your fireplace. C peptide is like the smoke, that just sort of like it doesn't really have a purpose. It's not going to give you heat, it smells nice, maybe. But it's

Scott Benner 6:30
a good measure that there's a fire somewhere,

Jennifer Smith, CDE 6:32
but it's a good measure that there's a fire somewhere. Exactly. So it's just a it's a marker, essentially. So that's it. That's why I kind of made that funny face at the comment. Because older insulin and I'd have to do some homework, but older insulin to my knowledge didn't really I mean, it wouldn't have had c peptide for a benefit of the insolent action.

Scott Benner 6:53
It makes me wonder if I hate to say this, like this, but it makes me wonder how sometimes people see things that aren't really there. Like maybe this person saw their c peptide, like falling more after they switch to more modern insulins and made the correlation or I mean, could could the older insulins have protected beta cells? No, right? There's no there's no I mean,

Jennifer Smith, CDE 7:23
really, the only protection from beta cells in the initial diagnostic time period is, the faster you get containment of your blood sugar, the less stress on those betas, as well as the knockdown of the immune system that is constantly trying to destroy them. So you, you add in sort of this outside insulin to keep the blood sugar's controlled, which means the betas don't have to work as hard. So you may in terms of that help preservation of the beta cells initially. So the better control from the beginning, the more betas you're likely to retain. Okay, well, in a general sense,

Scott Benner 8:03
let's combine this, let's just keep going for a second. I know this probably seems overly simplistic, but maybe it isn't.

Alright, so we've already talked about the Omni pod. And you can go check out that free 30 day trial of the dash system at Omni pod comm forward slash juicebox, as well as demo pods and just go see if you're eligible. But we still haven't spoken about the Dexcom g six today@dexcom.com forward slash juice box, you can learn more about the Dexcom g six Siri integration. It's indicated for children two and above that you can share your data with up to 10 followers. And that there are smart device compatibility with tons of phones that are both Android and iPhone. There are customizable alerts and alarms that will let you know if you're heading higher or lower, and leaving the range that you get to set. There's so much going on with the Dexcom g six, it gives back. You know what I was gonna say gives back data that helps us make great decisions, but it just gives back if you use man made insulin, the Dexcom g six is a friend. Check it out@dexcom.com forward slash juicebox. There you can get started with the Dexcom g six to tiny bit of information that you fill out and you're on your way. The Dexcom g six is one of the best decisions we've ever made for my daughter, my daughter and I use the Dexcom g six every day, every three days not even enough. We just use it constantly. It's there, but it needs to be there. It's not in the way when it doesn't. Check it out. Last thing before Jenny and I define beta cells and some other stuff. Don't forget to go touched by type one.org and follow them on Facebook and Instagram touched by type one.org. Just go check them out, you'll be happy that you did.

A beta cell is a type of cell found in the pancreatic isolettes that synthesize and secrete insulin and Amylin. beta cells make up 50 to 70% of the cells in human isolettes. in patients with type one diabetes, beta cell, mass and function are diminished, leading to insufficient insulin secretions and hyperglycemia. I guess we need to tell people what beta cells are just because they came up and I've never said it out loud on this podcast once I don't think so. I'm gonna do my best and then you're gonna tell me everywhere I'm wrong. But again, going back to an episode I did recently, I found out that beta cells are like, the only have like a gram of them in your body. It's apparently it's

Jennifer Smith, CDE 11:05
tiny.

Scott Benner 11:07
Yeah, yeah. So okay, let's figure that out. The pancreas

Jennifer Smith, CDE 11:09
is a very tiny, it's really actually it's a gland. So the your, your pancreas is tiny, comparative to the very large organs like your liver and your stomach and your heart and everything. I mean, the pancreas is this tiny little brain.

Scott Benner 11:27
That when that was said, again, I think in Episode 451, I was like, Ha, really, like, you know, like, I do love doing this podcast, because people say things. I'm like, I never do that. But, uh, but so there are these, these beta cells, and their job right? make insulin, and Amylin, which I guess we have to say now, but Amazon is because we keep bringing things. But So in a nutshell, what do they do?

Jennifer Smith, CDE 11:54
So the I mean, the the definition of a beta cell really is just, it's any of the cells in the islets.

Scott Benner 12:03
islets of langerhans is really, that it's insulin producing cells as a beta cell. That's essentially what it does. It makes insulin and Amylin or Jesus, I split amyloid poly peptide is a 37 residue peptide hormone, it is co secreted with insulin from the pancreatic beet beta cells in the ratio of approximately 100 to one. So does that are we not getting Amylin, either? If you have Type One Diabetes called

Unknown Speaker 12:36
sembalun on the market, you know, both sembalun

Unknown Speaker 12:39
I have heard about someone? Yes, yeah,

Jennifer Smith, CDE 12:42
it's an injectable form of amlan. It's so in the simplest term, yes. If you have type one, and you have beta cell issue, obviously, you're not producing insulin, well, if you have beta cell destruction, because Amylin is also produced there. You also have a lack of amlan. An amlan is, like I said, there is an injectable form of it now on the market is going on the market for a long time, actually called sembalun. And it's essentially, I mean, it's a, it's a piece that helps in the way that insulin is used after secreted in terms, mostly around meal time management. So, people who use similasan as a addition to their diabetes management, they take similar, it's an injectable doesn't come as a pill. So it's an injectable that you take along with meals. What it does is it helps to slow some of the fast digestive nature of that spike in the aftermath of a meal. It also helps to for many helps to reduce a bit the amount of actual insulin that you need to cover the meal. So you get a slower glycemic

Scott Benner 14:10
response from a meal, helping to prevent spiking. It also for many, like I said, helps to bring down the amount of insulin to actually cover the meal. The ADA says Amylin is a peptide hormone that is co secreted with insulin from the pancreatic pieces, beta cells and is thusly and and is thus deficient in diabetic people. It inhibits glucagon secretion, delays, gastric emptying, and acts as a satiating agent, so helps you feel full.

Unknown Speaker 14:44
Yes,

Jennifer Smith, CDE 14:44
I actually have somebody I work with. I've not worked with her for about two years or so. But she actually used the tiniest dose of similar or Amlin in the afternoon, because that was her time that she just she couldn't get over her. appetite. He just was so hungry in the afternoon despite eating really good lunch starting with a breakfast, you know, all the tricks that we aim to do, you know, for like decreasing the amount that you might eat. But similan did the trick. He didn't actually, I mean, she kind of used it in an off label sense. She just took the tiniest amount in the afternoon, sort of around like two o'clock ish, her snacking kind of came into play by about four. And so just that tiny amount of the amblin in her system helped to decrease her desire for food into the afternoon.

Scott Benner 15:35
Okay. sembalun is an injectable medicine for adults with type two and type one diabetes to control blood sugar, similar and slows down the movement of food through your stomach affects how fast sugars enter your blood system after eating is always used with insulin to help lower blood sugar during the three hours. Which which by the way, I made a joke with someone the other day, I said, I'm very good at managing blood sugars, and I can't pronounce post Pratt. No. I said that's my, that's my genius. I don't know how to say that. And, and I still understand what it means. I'm wondering as I'm sitting here, how many weight weight loss doctors use similan off label?

Jennifer Smith, CDE 16:21
I wouldn't. Yeah, that would be a good question. I don't know. I don't even know if it would be without a diagnosis without a diagnosis of diabetes had really question because there are a lot of other. There are a lot of other meds that are specific more for weight management. Well, I

Scott Benner 16:40
found my answer already. It says that using it off label without diabetes, could endanger patients due to a higher risk of hypoglycemia. Okay, can make you Well, yeah.

Jennifer Smith, CDE 16:50
Because it really does suppress glucagon excretion. Right? And so if you have a decrease of that you also have less chance of your body responding to lows. Yeah, true like it's supposed to.

Scott Benner 17:03
So it doesn't have it doesn't have any use outside of people who have diabetes. Interesting. From what I've heard. Yeah, that's interesting. All right. We did it right. Hey, we said but beta cells all we said was c peptide ever somehow got into Amylin, which took us the similan and now we're done.

Unknown Speaker 17:21
Yay.

Scott Benner 17:27
I'd like to thank Omni pod Dexcom and touched by type one for sponsoring this episode of the Juicebox Podcast. Learn more about touched by type one at touched by type one.org or follow them on Facebook, and Instagram. Don't forget to see if you're eligible for the free 30 day trial the Omni pod dash at Omni pod.com forward slash juice box. And of course check into that Dexcom g six continuous glucose monitor@dexcom.com forward slash juicebox. There are links in the show notes of your podcast player and at Juicebox Podcast comm all of the sponsors and there's even a way for you to contact Jenny in there.