C-Peptide in children with juvenile diabetes

Abstract

Serum C-peptide, insulin-binding IgG and total insulin (IRI) were determined in 96 juvenile diabetics aged 4-21 years, with onset of diabetes at the age of 1-16 years and with 2-17 years' duration of diabetes. Thirty-four patients (35.4%) had detectable levels of C-peptide (greater than or equal to 0.04 pmol/ml). Compared to non-diabetic adults, 19 had values below the normal range, 12 showed values within the normal range (0.18-0.63 pmol/ml) and 3 rated above normal. There was a negative correlation between the fasting C-peptide concentration and the degree of ketonuria at the onset of diabetes and a positive correlation between C-peptide levels and the incidence of post-initial remission periods. Patients without detectable C-peptide had significantly higher levels of insulin antibodies than those who had detectable levels of C-peptide. The possibility of a relationship between the intensity of the initial treatment of diabetes and the preservation of the B-cell function is discussed, as well as the possibility of insulin antibodies being a cause of B-cell exhaustion.

Prevalence of residual B-cell function in insulin-treated diabetics evaluated by the plasma C-peptide response to intravenous glucagon

“…The C-peptide concentration in plasma reported in insulin-treated patients with diabetes of short duration suggests, however, that residual B-cell function is retained in the majority of such patients [4,5,6]. The results from the present study show that residual B-cell function is present in most insulin-treated diabetics for the first five years of treatment.…”

“…It has been demonstrated that, within the first year of treatment, most diabetics on insulin have a much reduced insulin secretion [4,5,6] and that, following a temporary respite within the first 2-5 months, insulin secretion decreases with time [7].…”

General immune dampening is associated with disturbed metabolism at diagnosis of type 1 diabetes

“…Young children, and especially those diagnosed soon after infections, tend to have less remaining C-peptide (17). Besides this fact, little is known about the heterogeneity of T1D with regard to disease process and clinical course.…”

Reduction of C-peptide secretion in noninsulin-dependent diabetic patients with long duration of insulin treatment.

“…Based on a study of Vol.30 in the patients who had diabetes for less than 5 years Grajwer et al, 1977;Ludvigsson and Heding, 1976;Hendrikson et al;. A similar correlation was found between short term (2 months to 2 years) and long term (5 to 8 years) insulin-dependent diabetic patients (Mirel et al, 1980).…”