Urban Poverty and Child Welfare

Titration of insulin dose in these patients requires serial insulin levels and or blood glucose levels. Obtaining serial insulin levels may often be difficult in a resource limited setting. As used in our patient, C-peptide levels could be used as a surrogate marker of insulin levels and could ease dose adjustment and titration during acute phases as well as during follow up. This could obviate the need for stringent blood glucose/insulin level moitoring during switch over to sulphonylureas from insulin therapy. We emphasize the utility of Cpeptide levels in titration of glibenclamide/ sulfonylureas and maintenance of euglycemia, which has not been reported earlier in TND(6).