Metabolic effect of islet B-cell function in insulin-treated diabetes.
We studied the relationship between endogenous insulin secretion and fasting levels of plasma free fatty acids (FFA), plasma acetoacetate plus plasma 3-hydroxybutyrate (total ketone bodies), blood glucose, and HbA1 in 132 diabetic outpatients treated with conventional insulin regimens. Patients were divided into four groups according to plasma C-peptide concentration after intravenous stimulation with glucagon: one group with C-peptide stimulation less than 0.06 nmol/l, one group with C-peptide stimulation 0.06- less than 0.32 nmol/l, one group with C-peptide stimulation 0.32- less than 0.60 nmol/l, and one group with C-peptide stimulation greater than 0.60 nmol/l. According to clinical criteria the prevalence of insulin-dependent diabetes mellitus was approximately 90% in patients with C-peptide stimulation less than 0.32 nmol/l, approximately 25% in patients with C-peptide stimulation from 0.32- less than 0.60 nmol/l, and approximately 10% in patients with C-peptide stimulation greater than 0.60 nmol/l. All metabolic variables were significantly higher in patients without detectable C-peptide in plasma when compared to values found in patients with C-peptide stimulation from 0.06- less than 0.32 nmol/l. These two patient groups also had similar peripheral plasma free insulin levels and were comparable according to age, sex, and body mass index.(ABSTRACT TRUNCATED AT 250 WORDS)
Gjessing
H J
HJ
Medical Department, Fredericia Hospital, Denmark.
Matzen
L E
LE
Iversen
S
S
Faber
O K
OK
Frøland
A
A
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D005215:Fasting; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000378:metabolism / Q000627:therapeutic use*; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000378:metabolism*; D007657:Ketone Bodies / Q000097:blood; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D002096:C-Peptide; D005230:Fatty Acids, Nonesterified; D006442:Glycated Hemoglobin; D007328:Insulin; D007657:Ketone Bodies