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Insulin and proinsulin in normal and chemical diabetic children
Insights
Children with chemical diabetes show elevated total immunoreactive insulin (TIRI) and sometimes elevated immunoreactive proinsulin (IRP) after glucose intake. However, increased TIRI levels, not IRP, appear to drive glucose intolerance in these pediatric cases.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Diabetes Research
Background:
- Chemical diabetes in children presents diagnostic challenges.
- Understanding insulin and proinsulin dynamics is crucial for pediatric metabolic health.
Purpose of the Study:
- To investigate plasma levels of total immunoreactive insulin (TIRI) and immunoreactive proinsulin (IRP) in children with chemical diabetes.
- To correlate these levels with glucose intolerance in the pediatric population.
Main Methods:
- Studied 10 normal children and 15 children (ages 5-13) with chemical diabetes.
- Measured plasma TIRI and IRP during fasting and after glucose administration.
Main Results:
- Eleven children with chemical diabetes had elevated fasting and post-glucose TIRI.
- Four children showed delayed TIRI response but normal levels; their IRP was normal.
- Remaining children with elevated TIRI also had elevated IRP post-glucose.
- Despite elevated IRP, increased TIRI was the primary factor in glucose intolerance.
Conclusions:
- Elevated TIRI, rather than IRP, is associated with glucose intolerance in pediatric chemical diabetes.
- Insulin resistance, indicated by high TIRI, is a key feature in these children.
- Further research into the mechanisms of insulin secretion and resistance in pediatric diabetes is warranted.
Abstract:
Plasma levels of total immunoreactive insulin and immunoreactive proinsulin were studied in 10 normal children and 15 children with chemical diabetes ranging in age from 5 to 13 years. Eleven of the children with chemical diabetes demonstrated significantly elevated TIRI during fasting and following glucose administration. There was a delay in the increment of plasma TIRI in four children with chemical diabetes, but otherwise their TIRI levels were normal. In these four children IRP was not significantly different from normal; however, in the remaining children with chemical diabetes, those with elevated TIRI, the IRP was elevated following glucose administration. Although the IRP was significantly elevated in the hyperinsulinemic group, the TIRI was also increased to such an extent that the glucose intolerance demonstrated in these patients could not be attributed to the elevated IRP.