Influence of combined C-peptide and insulin administration on renal function and metabolic control in diabetes type 1.
The possible influence of C-peptide on renal function and metabolic control in patients with type 1 diabetes was examined in a double blind, randomized study. Nine patients received insulin and equimolar amounts of biosynthetic human C-peptide for 1 month (group 1), and nine were given insulin only (group 2). C-Peptide levels in plasma ranged from 0.3-2.6 nmol/L in group 1 during the study, whereas group 2 had undetectable levels. The urinary excretion of albumin in group 1 was 21 +/- 6 micrograms/min before the study and decreased by 40% and 55% after 2 and 4 weeks, respectively (P < 0.05). No change was seen in group 2. The glomerular filtration rate fell by 6% after 2 and 4 weeks (P < 0.05) in group 1, whereas no change was observed in group 2. Fluorescein leakage across the blood-retinal barrier decreased by 30% in group 1 (P < 0.05) and was unaltered in group 2. Hemoglobin-A1c and fructosamine values decreased by 9-16% in group 1 (P < 0.05), but not in group 2. The findings suggest that administration of C-peptide plus insulin, compared to insulin alone, to type 1 diabetic patients may reduce glomerular permeability and improve metabolic control.
Johansson
B L
BL
Department of Clinical Physiology, Karolinska Hospital, Stockholm, Sweden.
Kernell
A
A
Sjöberg
S
S
Wahren
J
J
D000293:Adolescent; D000328:Adult; D000419:Albuminuria; D001786:Blood Glucose / Q000187:drug effects; D001813:Blood-Retinal Barrier / Q000187:drug effects; D002096:C-Peptide / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D019793:Fluorescein; D005452:Fluoresceins / Q000493:pharmacokinetics; D019270:Fructosamine; D005919:Glomerular Filtration Rate / Q000187:drug effects; D005934:Glucagon / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D013006:Growth Hormone / Q000097:blood; D006595:Hexosamines / Q000097:blood; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D009638:Norepinephrine / Q000097:blood; D010865:Pilot Projects
D001786:Blood Glucose; D002096:C-Peptide; D019793:Fluorescein; D005452:Fluoresceins; D019270:Fructosamine; D005934:Glucagon; D006442:Glycated Hemoglobin; D013006:Growth Hormone; D006595:Hexosamines; D007328:Insulin; D009638:Norepinephrine