Illustration of pancreas and blood vessels symbolizing diabetes risk assessment.

Unlocking Diabetes Insights: How a Simple Test Can Reveal Hidden Risks

Nico Varela in Health & Wellness December 2025 • 4 min read.

"Could a quick glucagon stimulation test (GST) be the key to understanding and preventing microvascular complications in type 2 diabetes?"

For individuals managing type 2 diabetes, understanding the risk of complications is crucial for maintaining long-term health. Microvascular complications, affecting the small blood vessels, can lead to serious issues such as retinopathy (eye damage), nephropathy (kidney damage), and neuropathy (nerve damage). Identifying these risks early can empower individuals and healthcare providers to take proactive steps toward prevention.

Traditionally, assessing these risks has involved various tests and monitoring of blood sugar levels. However, emerging research suggests a simpler method may offer valuable insights: the glucagon stimulation test (GST). This test measures how well the pancreas responds to glucagon by releasing C-peptide, a substance produced alongside insulin.

A recent study investigated the relationship between stimulated C-peptide levels, measured through the GST, and the presence of microvascular complications in patients with type 2 diabetes. The findings suggest that this test could be a useful tool for identifying individuals at higher risk, allowing for earlier and more targeted interventions.

The C-Peptide Connection: What the GST Reveals About Diabetes Risks

Illustration of pancreas and blood vessels symbolizing diabetes risk assessment.

The study, published in the journal Diabetes & Metabolism, involved 192 patients with type 2 diabetes. Researchers measured both basal C-peptide levels (before glucagon injection) and stimulated C-peptide levels (six minutes after injection). They then analyzed the relationship between these levels and the presence of retinopathy, nephropathy, and neuropathy.

The results revealed a significant association between stimulated C-peptide levels and microvascular complications:

Retinopathy: Patients with retinopathy had significantly lower stimulated C-peptide levels compared to those without.
Nephropathy: Similarly, patients with nephropathy also exhibited lower stimulated C-peptide levels.
Overall Risk: Higher stimulated C-peptide levels were associated with an increased prevalence of microvascular complications, even after adjusting for factors like age, diabetes duration, and blood sugar control (HbA1c).

These findings suggest that the glucagon stimulation test can provide valuable information about a person's risk of developing microvascular complications. Stimulated C-peptide levels appear to be a more sensitive indicator than basal C-peptide levels alone.

Empowering Proactive Diabetes Management: The Future of Risk Assessment

This research highlights the potential of the glucagon stimulation test as a relatively simple and short-duration method for assessing C-peptide response in patients with type 2 diabetes. The association between stimulated C-peptide levels and microvascular complications underscores the importance of proactive diabetes management.

By identifying individuals at higher risk, healthcare providers can implement targeted interventions, such as lifestyle modifications, medication adjustments, and closer monitoring for early signs of complications. This personalized approach can help preserve β-cell function, slow the progression of the disease, and ultimately improve long-term health outcomes.

While further research is needed to confirm these findings and explore the optimal use of the GST in clinical practice, this study offers a promising step towards more effective risk assessment and prevention strategies for individuals living with type 2 diabetes.

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This article is based on research published under:

DOI-LINK: 10.4093/dmj.2012.36.5.379, Alternate LINK

Title: Correlations Between Glucagon Stimulated C-Peptide Levels And Microvascular Complications In Type 2 Diabetes Patients

Subject: Endocrinology, Diabetes and Metabolism

Journal: Diabetes & Metabolism Journal

Publisher: Korean Diabetes Association

Authors: Hye-Jin Yoon, Youn-Zoo Cho, Ji-Young Kim, Byung-Joon Kim, Keun-Young Park, Gwan-Pyo Koh, Dae-Ho Lee, Dong-Mee Lim

Published: 2012-01-01

Everything You Need To Know

What exactly is a glucagon stimulation test, and what does it measure?

The glucagon stimulation test (GST) is a medical procedure used to assess how well the pancreas functions in individuals with type 2 diabetes. It involves measuring C-peptide levels before and after an injection of glucagon. The change in C-peptide levels provides insights into the pancreas's ability to produce insulin, which is crucial for regulating blood sugar and preventing microvascular complications.

Why are microvascular complications important in type 2 diabetes?

Microvascular complications, including retinopathy, nephropathy, and neuropathy, are significant in the context of type 2 diabetes because they can lead to severe health issues. Retinopathy can cause vision loss, nephropathy can result in kidney failure, and neuropathy can lead to nerve damage and various complications. The study's findings suggest that the glucagon stimulation test (GST) can help identify those at higher risk, enabling early intervention.

Why is the glucagon stimulation test considered significant in the context of diabetes management?

The glucagon stimulation test (GST) is considered important because it can offer a relatively quick and straightforward way to assess the risk of microvascular complications in type 2 diabetes. The study indicates that lower stimulated C-peptide levels, measured via the GST, are associated with a higher prevalence of retinopathy and nephropathy. This enables proactive management, like adjusting treatment plans or lifestyle changes, to potentially slow the progression of these complications.

What are the implications of the glucagon stimulation test findings for people with type 2 diabetes?

The implications of the glucagon stimulation test (GST) findings are significant. The test can help to personalize diabetes care. The ability to identify patients at higher risk through the GST allows healthcare providers to implement targeted interventions, such as intensive glucose control or other treatments, sooner. Early intervention may help to delay or prevent the onset of microvascular complications, significantly improving the long-term health outcomes for those with type 2 diabetes. The test's association with microvascular complications, even after adjusting for factors like age and blood sugar control (HbA1c), indicates its potential clinical utility.

What is C-peptide and why is it relevant to understanding diabetes risks?

C-peptide is a substance produced by the pancreas along with insulin. Measuring C-peptide levels, both before and after glucagon injection during the glucagon stimulation test (GST), helps to evaluate how well the pancreas is responding to glucagon by releasing C-peptide, and, consequently, the ability to produce insulin. The GST helps to evaluate if the pancreas is functioning properly. Lower stimulated C-peptide levels are linked to a higher risk of microvascular complications.