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Proinsulin Secretion Is a Persistent Feature of Type 1 Diabetes.
- Source :
-
Diabetes care [Diabetes Care] 2019 Feb; Vol. 42 (2), pp. 258-264. Date of Electronic Publication: 2018 Dec 10. - Publication Year :
- 2019
-
Abstract
- Objective: Abnormally elevated proinsulin secretion has been reported in type 2 and early type 1 diabetes when significant C-peptide is present. We questioned whether individuals with long-standing type 1 diabetes and low or absent C-peptide secretory capacity retained the ability to make proinsulin.<br />Research Design and Methods: C-peptide and proinsulin were measured in fasting and stimulated sera from 319 subjects with long-standing type 1 diabetes (≥3 years) and 12 control subjects without diabetes. We considered three categories of stimulated C-peptide: 1 ) C-peptide positive, with high stimulated values ≥0.2 nmol/L; 2 ) C-peptide positive, with low stimulated values ≥0.017 but <0.2 nmol/L; and 3 ) C-peptide <0.017 nmol/L. Longitudinal samples were analyzed from C-peptide-positive subjects with diabetes after 1, 2, and 4 years.<br />Results: Of individuals with long-standing type 1 diabetes, 95.9% had detectable serum proinsulin (>3.1 pmol/L), while 89.9% of participants with stimulated C-peptide values below the limit of detection (<0.017 nmol/L; n = 99) had measurable proinsulin. Proinsulin levels remained stable over 4 years of follow-up, while C-peptide decreased slowly during longitudinal analysis. Correlations between proinsulin with C-peptide and mixed-meal stimulation of proinsulin were found only in subjects with high stimulated C-peptide values (≥0.2 nmol/L). Specifically, increases in proinsulin with mixed-meal stimulation were present only in the group with high stimulated C-peptide values, with no increases observed among subjects with low or undetectable (<0.017 nmol/L) residual C-peptide.<br />Conclusions: In individuals with long-duration type 1 diabetes, the ability to secrete proinsulin persists, even in those with undetectable serum C-peptide.<br /> (© 2018 by the American Diabetes Association.)
Details
- Language :
- English
- ISSN :
- 1935-5548
- Volume :
- 42
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Diabetes care
- Publication Type :
- Academic Journal
- Accession number :
- 30530850
- Full Text :
- https://doi.org/10.2337/dc17-2625