A study published in the Canadian Medical Association Journal has found that elevated levels of c-peptide in non-diabetic people is a predictor of death.

C-peptide is a marker of insulin production but has also been shown to indicate insulin resistance and cardiovascular disease in non-diabetic people.

C-peptide levels are used as a biomarker in diabetes. T2D presents excess levels of c-peptide, whereas T1D presents nearly undetectable c-peptide levels.

This study investigated the role C-peptide levels play in death of adults without diabetes. The participants were sorted into 4 groups, based on C-peptide levels. They were then sorted by cause of death: all-cause, cardiovascular disease-related and coronary artery disease-related.

Causes of death were analyzed in over 5,900  participants aged 40 years and older. These people did not have a history of diabetes and had available blood C-peptide levels from the baseline examination.

Cardiovascular disease accounts for 65–75% of deaths in people with T1D but their death is not due to a c-peptide overabundance. In fact, people with T1D have almost undetectable c-peptide. The same cause of their diabetes, autoimmunity, is the cause of death resulting from cardiovascular disease.

In people without diabetes, lower the c-peptide levels predict that it is less likely they would die from cardiovascular disease or coronary artery disease. This begs the question why is c-peptide so helpful for T1D and potentially harmful for T2D?

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