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Persistent insulin secretion, assessed by plasma C-peptide estimation in long-term juvenile diabetics with a low

C Eff, O Faber, T Deckert

    Diabetologia
    |September 1, 1978
    PubMed

    Insights

    Many long-term juvenile diabetes patients with low insulin needs retain some beta-cell function, indicated by C-peptide levels. This residual insulin production may correlate with lower rates of severe retinopathy.

    Area of Science:

    • Endocrinology
    • Metabolic Diseases
    • Diabetes Research

    Background:

    • Juvenile diabetes mellitus (Type 1 diabetes) often requires lifelong insulin therapy.
    • Patients with long-standing diabetes and low insulin requirements (<0.50 units/kg/day) are studied to assess residual beta-cell function.

    Purpose of the Study:

    • To determine if patients with long-standing juvenile diabetes and low insulin needs possess functioning beta-cells.
    • To investigate the relationship between residual insulin production and diabetes complications like retinopathy.

    Main Methods:

    • Plasma C-peptide levels were measured after stimulation (oral glucose tolerance test, glucagon/tolbutamide) in 64 patients.
    • Diabetes duration averaged 31 years (minimum 18 years).
    • Insulin requirements, insulin antibodies, metabolic control, and retinopathy prevalence were assessed.

    Main Results:

    • Measurable endogenous insulin production (C-peptide secretion) was detected in 24% of patients.
    • The prevalence of severe retinopathy was significantly lower in patients with residual insulin production (secretors) compared to non-secretors.
    • Insulin requirements remained relatively constant in secretors, and metabolic control was similar between secretors and non-secretors.

    Conclusions:

    • A significant proportion of long-term juvenile diabetics with low insulin needs exhibit persistent, albeit low, endogenous insulin production.
    • Residual beta-cell function may be a protective factor against severe retinopathy in these patients.
    • Some patients develop low insulin requirements due to unknown factors, independent of residual beta-cell function.

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