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C-peptide in children with juvenile diabetes. A preliminary report
Insights
In juvenile diabetics, detectable C-peptide indicates preserved beta-cell function. Higher insulin antibodies correlate with lower C-peptide levels, suggesting potential B-cell exhaustion.
Area of Science:
- Endocrinology
- Immunology
- Metabolic Disorders
Background:
- Juvenile diabetes mellitus (JDM) is characterized by autoimmune destruction of pancreatic beta cells.
- Assessing residual beta-cell function is crucial for understanding disease progression and treatment strategies in JDM.
Purpose of the Study:
- To evaluate serum C-peptide levels and their correlation with insulin antibodies in juvenile diabetics.
- To investigate factors influencing beta-cell function preservation in JDM.
Main Methods:
- Serum C-peptide, insulin-binding IgG, and total insulin (IRI) were measured in 96 juvenile diabetics.
- Patients' age at onset, duration of diabetes, and presence of ketonuria were recorded.
Main Results:
- 35.4% of patients had detectable C-peptide levels, indicating residual beta-cell function.
- Lower C-peptide levels correlated with increased ketonuria at onset and higher insulin antibody levels.
- Patients with undetectable C-peptide had significantly higher insulin antibodies.
Conclusions:
- Residual beta-cell function (indicated by C-peptide) is present in a significant subset of juvenile diabetics.
- Insulin antibodies may play a role in beta-cell exhaustion and loss of function in JDM.
- Further research is needed to explore the impact of initial treatment intensity on beta-cell preservation.
Abstract:
Serum C-peptide, insulin-binding IgG and total insulin (IRI) were determined in 96 juvenile diabetics aged 4-21 years, with onset of diabetes at the age of 1-16 years and with 2-17 years' duration of diabetes. Thirty-four patients (35.4%) had detectable levels of C-peptide (greater than or equal to 0.04 pmol/ml). Compared to non-diabetic adults, 19 had values below the normal range, 12 showed values within the normal range (0.18-0.63 pmol/ml) and 3 rated above normal. There was a negative correlation between the fasting C-peptide concentration and the degree of ketonuria at the onset of diabetes and a positive correlation between C-peptide levels and the incidence of post-initial remission periods. Patients without detectable C-peptide had significantly higher levels of insulin antibodies than those who had detectable levels of C-peptide. The possibility of a relationship between the intensity of the initial treatment of diabetes and the preservation of the B-cell function is discussed, as well as the possibility of insulin antibodies being a cause of B-cell exhaustion.