Effects of C-peptide on insulin-induced hypoglycaemia and its counterregulatory responses in IDDM patients.
Recent studies indicate that C-peptide, when given to patients with insulin-dependent (Type 1) diabetes mellitus (IDDM), exerts significant effects on microvascular and neuronal functions. Adjuvant therapy with C-peptide has been advocated in the treatment of IDDM patients. Since endogenous insulin secretion is believed to be of importance for the alpha-cell function, we addressed the issue whether C-peptide given acutely interferes with the responses to hypoglycaemia. Seven IDDM patients were randomly exposed to hypoglycaemia with and without exogenous C-peptide. Insulin and and C-peptide were given intravenously in equimolar amounts for 3 hours. The decrease of blood glucose was faster and more pronounced during C-peptide infusion, yielding a significantly lower AUC 0-180 min of blood glucose (38.5 +/- 1.6 vs 44.4 +/- 2.2 mmol l(-1)h(-1); p = 0.032). No difference between the two experiments was found concerning glucagon when the AUC, delta-values or levels at separate points of time were calculated. In conclusion, the main finding of this study was that exogenous C-peptide, given acutely, gave rise to a more rapid onset of hypoglycaemia yielding no detectable differences with respect to the response of glucagon and other counterregulatory hormones.
Oskarsson
P
P
Department of Medicine, Danderyd Hospital, Sweden.
Johansson
B L
BL
Adamson
U
U
Lins
P E
PE
D000328:Adult; D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000008:administration & dosage / Q000494:pharmacology*; D002851:Chromatography, High Pressure Liquid; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D004837:Epinephrine / Q000097:blood; D005260:Female; D005934:Glucagon / Q000097:blood; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D010865:Pilot Projects; D011863:Radioimmunoassay
D001786:Blood Glucose; D002096:C-Peptide; D007004:Hypoglycemic Agents; D007328:Insulin; D005934:Glucagon; D004837:Epinephrine