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  • 1
    Electronic Resource
    Electronic Resource
    Plasma C-peptide and serum insulin antibodies in diabetic patients receiving pancreatic transplants (1980)
    Springer
    Diabetologia 19 (1980), S. 25-30 
    Details
    ISSN: 1432-0428
    Keywords: C-peptide ; insulin antibodies ; glucose tolerance ; segmental pancreatic transplantation ; pancreatic transplant rejection ; brittle diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Plasma C-peptide and serum insulin antibody levels were determined in 5 diabetic patients undergoing vascularized pancreatic transplantation. The grafts functioned well at first and exogenous insulin could be withdrawn, but one to 7 weeks later the grafts were rejected. After the transplantation there was an increase in the fasting plasma C-peptide level, and B-cell stimulation with glucose or glucagon evoked a C-peptide response. Healing of ischaemic damage was reflected in an increase in the C-peptide level. During graft rejection the C-peptide level fell. Measurement of plasma C-peptide levels provides a direct index of the B-cell function of the pancreatic graft. After transplantation the insulin antibody level fell exponentially, with an apparent half life of 10–11 days, whereas the level of total IgG was variable. The results indicate that formation of insulin antibodies ceases immediately on removal of the immunogenic stimulus, that is, on withdrawal of xenogeneic insulin.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00258306
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Residual insulin production, glycaemic control and prevalence of microvascular lesions and polyneuropathy in long-term Type 1 (insulin-dependent) diabetes mellitus (1987)
    Springer
    Diabetologia 30 (1987), S. 208-213 
    Details
    ISSN: 1432-0428
    Keywords: C-peptide ; insulin-dependent diabetes ; albuminuria ; proteinuria ; haemoglobin a1c
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aim of the present study was to evaluate the role of residual insulin production in long-term Type 1 (insulin-dependent) diabetes mellitus. Ninety-seven patients with a disease duration of 9–16 years and onset before the age of 30 years were studied. C-peptide excretion in 24-h urine samples was measured as an indicator of residual insulin production. Thirty-five patients (36%) excreted C-peptide (〉-0.2 nmol); as many as possible of them were carefully matched with a non-excretor patient with regard to age at onset of diabetes and disease duration. Twenty-nine pairs were obtained, and 22 of them agreed to participate in further investigations of glycaemic control and microangiopathic lesions. The patients who excreted C-peptide had significantly lower HbA1c than the non-excretor group, 6.9±0.3% vs 7.9±0.3%, (p〈0.025). Moderate-to-advanced background retinopathy was found in 2 patients in the excretor group and in 7 patients in the nonexcretor group. Microalbuminuria [ratio of albumin: creatinine (mg/l:mmol/l) 〉-5] was found in 1 and in 5 patients, respectively, while proteinuria [ratio of protein: creatinine (mg/l: mmol/l× 10) 〉-136] was found in 0 and in 4 patients, respectively. Microalbuminuria and/or proteinuria was found in 7 of the non-excretor group as compared to 1 in the excretor group (p=0.046). When all the variables were taken into account, microalbuminuria and/or proteinuria and/or moderate-to-advanced background retinopathy was found in 3 of the excretor group compared to 11 of the non-excretor group (p=0.022). Reduced sensory and motor nerve conduction velocities were common findings and occurred with the same frequency in the two groups. The data suggest that residual insulin production in long-term Type 1 diabetes is associated with a more satisfactory glycaemic control and a lower prevalence of early microangiopathic eye and kidney lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00270417
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Renal and splanchnic exchange of human biosynthetic C-peptide in Type 1 (insulin-dependent) diabetes mellitus (1991)
    Springer
    Diabetologia 34 (1991), S. 423-428 
    Details
    ISSN: 1432-0428
    Keywords: Glucose utilization ; Type 1 (insulin-dependent) diabetes mellitus ; human C-peptide ; glucagon ; renal uptake ; hepatic uptake
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Biosynthetic human C-peptide or NaCl (154 mmol·l−1) was given intravenously to 13 Type 1 (insulin-dependent) diabetic patients to determine the renal and splanchnic exchange of C-peptide. Catheters were inserted percutaneously into an artery and a renal and hepatic vein. Infusions of C-peptide were given for 60 min at two dose levels (5 and 30 pmol·kg−1·min−1). Insulin was infused throughout the study (0.5 mU·kg−1·min−1) and plasma glucose was kept constant by a variable glucose infusion. The regional blood flows were measured by indicator dilution techniques. In 11 of the 13 patients basal C-peptide levels were not detectable. The arterial steady-state C-peptide concentration was 0.81±0.10 nmol·l−1 and 2.33±0.30 nmol·l−1 at the low and high rate infusions, respectively. Renal uptake was 124±18 pmol·min−1 at the low infusion corresponding to 39% of the infused amount. At the higher dose C-peptide infusion renal uptake increased to 155±21 pmol·min−1 (p〈0.05). Urinary excretion of C-peptide was 7±2 pmol·min−1 at the low dose infusion and increased to 34±6 pmol·min−1 at the high dose infusion (p〈0.01). The proportions of infused amount excreted were fairly constant and between 2% and 3%. No net exchange of C-peptide was found across the splanchnic vascular bed. The rate of glucose infusion had to be increased by 35% during the low dose C-peptide, but not during NaCl infusion in order to maintain a constant plasma glucose concentration. Arterial plasma concentrations of noradrenaline increased by 15–25% during both C-peptide and NaCl infusions. It is concluded that in patients with Type 1 diabetes (a) the kidney is the primary site of C-peptide removal, (b) renal metabolism rather than urinary excretion is the dominating process for C-peptide elimination (c) the excreted proportions of an infused amount of C-peptide were fairly constant between 2% and 3% and (d) no hepatic C-peptide catabolism could be detected.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403181
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    Paper (German National Licenses)
    Fulltext
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