The insulin stuff is complicated, and I usually have to read a paper 10,000 times before I understand it, and then I forget the technical terms within minutes.
In very simple terms, when insulin is produced naturally by a healthy adult, C-peptides are produced at the same rate; the insulin and C-peptides are then cleared at a similar rate by the liver and kidneys. Because of this steady ratio of C-peptide to natural insulin, we use C-peptide measurements to assess the rate at which diabetics naturally produce insulin, since synthetic insulin doesn't produce the same C-peptide levels - it allows Drs to differentiate between synthetic and naturally occurring insulin.
In none diabetics who have not been given synthetic insulin, you would expect the C-peptides and insulin levels to be roughly the same. This has never been tested as thoroughly in newborns, especially in neonates, because they just don't have enough blood, so Drs have always just calculated down from the adult ratios to work out babies' and neonates' C/I ratios, which is what happened in the Letby case and how they came to the conclusion that synthetic insulin had been given.
However, newish research by Chase and Shannon shows that neonates have a similar antibody to diabetics that can bind and store insulin, which skews the C/I ratio.
The papers are all paid for, and I am not sure my nurse sister would be impressed with me giving out her log-on details so you can all read them, but this Reddit thread discusses the paper Chase and Shannon wrote for Letby's appeal and papers they referenced in their own.
www.reddit.com/r/LucyLetbyTrials/comments/1sy75b6/geoff_chase_helen_shannon_study_now_published/