Effect of C-peptide on diabetic neuropathy in patients with type 1 diabetes.
Recent results indicate that proinsulin C-peptide, contrary to previous views, exerts important physiological effects and shows the characteristics of a bioactive peptide. Studies in type 1 diabetes, involving animal models as well as patients, demonstrate that C-peptide in replacement doses has the ability to improve peripheral nerve function and prevent or reverse the development of nerve structural abnormalities. Peripheral nerve function, as evaluated by determination of sensory nerve conduction velocity and quantitative sensory testing, is improved by C-peptide replacement in diabetes type 1 patients with early stage neuropathy. Similarly, autonomic nerve dysfunction is ameliorated following administration of C peptide for up to 3 months. As evaluated in animal models of type 1 diabetes, the improved nerve function is accompanied by reversal or prevention of nerve structural changes, and the mechanisms of action are related to the ability of C-peptide to correct diabetes-induced reductions in endoneurial blood flow and in Na+ K+-ATPase activity and modulation of neurotrophic factors. Combining the results demonstrates that C-peptide may be a possible new treatment of neuropathy in type 1 diabetes.
Ekberg
Karin
K
Department of Molecular Medicine and Surgery, Karolinska Institute, 17176 Stockholm, Sweden. karin.ekberg@creativepeptides.se
Johansson
Bo-Lennart
BL
D000328:Adult; D002096:C-Peptide / Q000627:therapeutic use*; D018849:Controlled Clinical Trials as Topic; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy; D003929:Diabetic Neuropathies / Q000188:drug therapy*; D006801:Humans
D002096:C-Peptide