[Basal C peptide levels in response to intravenous tolbutamide in the detection of incorrect insulin therapy (or prolonged misuse)].
Fifty nine insulin dependant diabetics were hospitalised for a trial withdrawal of insulin: 17 patients rapidly showed signs of lack of insulin, 18 did not develop cetoacidosis but could not be stabilised on diet and oral hypoglycemic agents, 24 were stabilised without insulin. A statistical study (multifactorial analysis of correlations, plotting of ROC graphs) validated the classification of these diabetics into 3 groups. It also showed that in patients with hypoglycemia, the values of C-protein, and after intravenous injection of tolbutamide, were good predictive factors for insulin-dependance: all patients with basal C-protein less than 1,9 ng/ml could not be stabilised without insulin; when the basal C-protein greater than or equal to 1,9 ng/ml and the amplitude of response at the 5th min was greater than or equal to 0,4 ng/ml, the diabetes could be stabilised by diet and oral hypoglycemic agents in 90 p. 100 of cases. This institutes an easy, reliable and economic method of detecting abusive insulin therapy.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002096:C-Peptide / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000097:blood*; D014044:Tolbutamide / Q000008:administration & dosage
D002096:C-Peptide; D007328:Insulin; D010455:Peptides; D014044:Tolbutamide
Le dosage du peptide C basal et en réponse au tolbutamide intraveineux dans le dépistage des insulinothérapies abusives (ou abusivement prolongées).