Beneficial effects of C-peptide on incipient nephropathy and neuropathy in patients with Type 1 diabetes mellitus

Authors: Johansson B.-L.; Borg K.; Fernqvist-Forbes E.; Kernell A.; Odergren T.; Wahren J.

Source: Diabetic Medicine, Volume 17, Number 3, March 2000 , pp. 181-189(9)

Publisher: Wiley-Blackwell

Abstract:

Aims Recent studies have indicated that proinsulin C-peptide shows specific binding to cell membrane binding sites and may exert biological effects when administered to patients with Type 1 diabetes mellitus. This study was undertaken to determine if combined treatment with C-peptide and insulin might reduce the level of microalbuminuria in patients with Type 1 diabetes and incipient nephropathy.

Methods Twenty-one normotensive patients with microalbuminuria were studied for 6 months in a double-blind, randomized, cross-over design. The patients received s.c. injections of either human C-peptide (600 nmol/24 h) or placebo plus their regular insulin regimen for 3 months.

Results Glycaemic control improved slightly during the study and to a similar extent in both treatment groups. Blood pressure was unaltered throughout the study. During the C-peptide treatment period, urinary albumin excretion decreased progressively on average from 58 g/min (basal) to 34 g/min (3 months, P < 0.01) and it tended to increase, but not significantly so, during the placebo period. The difference between the two treatment periods was statistically significant (P < 0.01). In the 12 patients with signs of autonomic neuropathy prior to the study, respiratory heart rate variability increased by 21 ± 9% (P < 0.05) during treatment with C-peptide but was unaltered during placebo. Thermal thresholds were significantly improved during C-peptide treatment in comparison to placebo (n = 6, P < 0.05).

Conclusion These results indicate that combined treatment with C-peptide and insulin for 3 months may improve renal function by diminishing urinary albumin excretion and ameliorate autonomic and sensory nerve dysfunction in patients with Type 1 diabetes mellitus.

Keywords: glomerular filtration rate; microalbuminuria; respiratory heart rate variability; thermal thresholds; vitreous flourophotometry

Language: English

Document Type: Research article

Publication date: 2000-03-01

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• In this Subject: Internal Medicine
• By this author: Johansson B.-L. ;  Borg K. ;  Fernqvist-Forbes E. ;  Kernell A. ;  Odergren T. ;  Wahren J.

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