Residual C-peptide excretion is associated with a better long-term glycemic control and slower progress of retinopathy in type I (insulin-dependent) diabetes mellitus

J Diabet Complications. Jan-Mar 1991;5(1):18-22. doi: 10.1016/0891-6632(91)90005-a.

Abstract

We evaluated the progression of microangiopathic lesions in 22 type I diabetic patients with residual C-peptide excretion and in 22 type I diabetic patients matched for age at onset and disease duration without residual C-peptide excretion. We also wished to elucidate whether certain HLA-DR phenotypes were associated with preserved insulin secretory activity and/or microvascular lesions. The two groups of patients were investigated in 1984 and 1985. In the previous report, we observed less frequent signs of early microangiopathic lesions in association with a lower HbA1c in the group with a detectable urinary C-peptide excretion. The HbA1c level has been measured regularly (7-12 times) since the initial investigation; the mean value was lower in the patient group with residual C-peptide excretion than in the non-C-peptide group (p = 0.01). Nine of the patients in the group without urinary C-peptide excretion had increased severity of retinopathy, but only two in the group with urinary C-peptide excretion (p = 0.04) had progression of retinopathy. Incipient and/or manifest albuminuria was observed in six of the nonexcretor group and one of the C-peptide excretors. Four of the patients were receiving antihypertensive treatment and three others had a diastolic blood pressure greater than or equal to 90 mmHg in the non-C-peptide excretor group as compared with one with a pressure greater than or equal to 90 mmHg in the C-peptide excretor group.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Albuminuria / blood
  • Antihypertensive Agents / therapeutic use
  • Blood Glucose / analysis*
  • C-Peptide / urine*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / metabolism*
  • Diabetic Retinopathy / metabolism*
  • Female
  • Follow-Up Studies
  • HLA-DR Antigens / analysis
  • Hemoglobin A / analysis
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy
  • Male
  • Time Factors

Substances

  • Antihypertensive Agents
  • Blood Glucose
  • C-Peptide
  • HLA-DR Antigens
  • Hemoglobin A