• Internal medicine · Dec 2023

    Case Reports

    Marked Increase in Urinary C-peptide Levels after Treatment with Sacubitril/Valsartan in Patients with Type 2 Diabetes Mellitus and Hypertension.

    • Yasuhiro Tanji, Shojiro Sawada, Takaki Numahata, Taichi Watanabe, Yuichiro Munakata, and Hiroaki Akai.
    • Division of Metabolism and Diabetes, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Japan.
    • Intern. Med. 2023 Dec 1; 62 (23): 350135063501-3506.

    AbstractSacubitril/valsartan, a novel therapy in chronic heart failure (CHF), inhibits the breakdown of various peptides. However, whether or not sacubitril/valsartan administration affects urinary C-peptide levels is unclear. We herein report a 70-year-old man with type 2 diabetes mellitus (T2DM) and hypertension coexisting with CHF and nephrotic syndrome. The patient's urinary C-peptide levels dramatically increased after sacubitril/valsartan administration and decreased after discontinuation of the drug. Furthermore, sacubitril/valsartan administration to five other patients with hypertension and T2DM markedly increased urinary C-peptide levels. Thus, the insulin secretory capacity of patients with T2DM receiving sacubitril/valsartan may be overestimated when their urinary C-peptide level is measured.

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