Type 2 High C peptide, high Hba1c

sounds like an unqualified gp. a high c peptide test means your family member has an insulin production a high one. its the insulin resistance thats bad not the insulin. your family member needs to lose weight and follow a low carb diet to reduce the resistance

I agree with @paulus1. The GP is talking nonsense. There is no 'bad' insulin. When the muscle cells etc are stuffed with stored fat your body's insulin can't get used. The pancreas produces more insulin to try to get the resulting high blood sugar down and the c-peptide shows this. The solution is to change the diet to low-carb and the weight will gradually go down. BTW Glimepiride's job is to stimulate the pancreas to produce MORE insulin and the GP has increased it? I think you need to have a discussion with the GP and ask (tell?) him how Glimepiride works and that may be you don't need it?

May I ask if you are in the UK, and if this doctor is in the UK?

paulus1 said:

sounds like an unqualified gp. a high c peptide test means your family member has an insulin production a high one. its the insulin resistance thats bad not the insulin. your family member needs to lose weight and follow a low carb diet to reduce the resistance

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Thing is Paul, how do we know he's overweight?

KK123 said:

Thing is Paul, how do we know he's overweight?

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fair point. should have said if overweight.

Rufat said:

No, neither us nor doctor is in UK.
He is not overweight but he doesn't keep diet. Thanks for help!
By the way doctor is not GP. Actually he is Endocrinologist and he should have known better.

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an Endocrinologist is a specilist doctor if they are not tell your family member to find a real one urgently. your family member must follow some type of restrictive diet or they are heading for health problems explain some of them. loss of legs eyes sight kidney damage increased risk of heart attacks and strokes. and if male impotence. if after that list a slight dietary adjustment does not sound good smack them a few times until they are listening.

Actually beta cell dysfunction does mean the production of poor quality insulin.The doctor may have been trying to make it simple for your Dad.

How high was his HBA1C?

Rufat said:

No, neither us nor doctor is in UK.
He is not overweight but he doesn't keep diet. Thanks for help!
By the way doctor is not GP. Actually he is Endocrinologist and he should have known better.

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Doesn't keep diet. I think that is his main problem right there. If can do something about that, as has already been suggested it should make a difference.

Yes, I agree with all of the above ie if folk are insulin resistant, then initially their pancreatic beta cells produce more insulin than usual to try and compensate; the greater insulin secretion might not be enough and hence the diabetes, and this is the major point. The body makes insulin by splitting pro-insulin into insulin and c-peptide, but when producing extra insulin, the split doesn't always happen at the usual place, and these other varieties of insulin don't work quite as well. C-peptide lasts in the blood stream longer than insulin (half life about 6 times longer) and accumulates if renal function is a bit impaired. The fact that the C-peptide level is up shows insulin production, but does not per se mean that medication needs to be increased; however, if medication needs to be increased (the HbA1c was high), an agent that sensitises the body to insulin would be a better bet than flogging the beta cells with more sulphonylurea.
Intersting question
best wishes