Influence of combined C-peptide and insulin administration on renal function and metabolic control in diabetes type 1

J Clin Endocrinol Metab. 1993 Oct;77(4):976-81. doi: 10.1210/jcem.77.4.8408474.

Abstract

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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Albuminuria
  • Blood Glucose / drug effects
  • Blood-Retinal Barrier / drug effects
  • C-Peptide / administration & dosage
  • C-Peptide / pharmacology
  • C-Peptide / therapeutic use*
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Double-Blind Method
  • Female
  • Fluorescein
  • Fluoresceins / pharmacokinetics
  • Fructosamine
  • Glomerular Filtration Rate / drug effects
  • Glucagon / blood
  • Glycated Hemoglobin A / analysis
  • Growth Hormone / blood
  • Hexosamines / blood
  • Humans
  • Insulin / administration & dosage
  • Insulin / pharmacology
  • Insulin / therapeutic use*
  • Insulin Infusion Systems
  • Kidney / drug effects*
  • Kidney / physiopathology
  • Male
  • Norepinephrine / blood
  • Pilot Projects

Substances

  • Blood Glucose
  • C-Peptide
  • Fluoresceins
  • Glycated Hemoglobin A
  • Hexosamines
  • Insulin
  • Fructosamine
  • Growth Hormone
  • Glucagon
  • Fluorescein
  • Norepinephrine