C-Peptide in Diabetic Children After Stimulatoin With Clucagon Compared With Fasting C-Peptide Levels in Non-Diabetic Children

Abstract

Fasting serum C-peptide and total immunoreactive insulin (IRI) were determined in 38 non-diabetic children and adolescents 6\p=n-\22 years old. C-peptide varied between 0.22\p=n-\0.73 pmol/ml (mean \m=+-\ sd, 0.45 \ m=+-\ 0.11). There was a tendency to higher values during puberty. No difference was found between subjects with or without a family history for diabetes. IRI varied between 0\p=n-\31 \g=m\U/ml(mean \ m=+-\ sd, 11.3 \ m=+-\ 6.5). The C-peptide response to glucagon was studied in 10 insulin dependent juvenile diabetics 11\p=n-\19 years old, who had had measurable amounts of fasting C-peptide on some occasions during the previous years. Duration of diabetes varied between 4\p=n-\12years. A slight but significant rise in C-peptide level occurred in 3 patients. Their metabolic control estimated on the basis of daily urinalysis was "excellent" or "good". The results support the hypothesis that even trace remnants of the beta cell function may be of importance for the metabolic control in juvenile diabetes.In a previous study we found that some juvenile diabetics with onset of dia¬ betes at the age of 1-16 years have signs of persisting beta cell function beyond the post-initial remission period as evident from measurable amounts of fasting serum C-peptide (Ludvigsson 8c Heding 1976). This residual beta cell func¬ tion seems to be of importance for the diabetic control Ludvigsson, to be publ.; Ludvigsson et al. 1977). However, comparisons between the C-peptide levels in diabetic and non-diabetic children could not 364

C-peptide reserve in insulin-dependent diabetes

“…Unger et al [25] and Faber and Binder [24,26] showed that increases in CPR levels occur after intravenous glucagon in diabetics. Finally, Ludvigsson and Heding reported that only 3 of 10 insulin-dependent diabetics whose mean duration of disease was 6.3 years had any C-peptide response to intravenous glucagon secretion [13]. In our group, 3/7 short-term but no longer term diabetics responded to glucagon with a mean increase of 0.62 pmol/ml compared with 0.92 pmol/ml in the normals described above.…”

“…While refinements of assay techniques for CPR have led to more precise evaluation of insulin reserve under a variety of conditions [8][9][10], little data is available comparing several provocative stimuli for C-peptide in the same group of patients. The present study was designed to evaluate beta cell reserve measured by CPR in insulin-dependent (type 1) diabetes employing three provocative stimuli: glucose, tolbutamide and glucagon [11][12][13]. Stimulation tests were performed in two groups of type 1 diabetics: those of recent onset (less than 2 years) and those of longer duration (greater than 5 years).…”

Photopheresis at onset of type 1 diabetes: a randomised, double blind, placebo controlled trial

“…C peptide in blood was measured according to the method of Heding,33 in the fasting state and after a standardised breakfast meal,29 30 and in urine collected overnight.…”

Treatment with antioxidants at onset of type 1 diabetes in children: a randomized, double-blind placebo-controlled study

“…A secondary, quite interesting result arising from the present study is the demonstration of quite high longterm C-peptide secretion in children with classical type 1 diabetes. The residual insulin secretion was clearly better than in corresponding groups of patients described previously at the same clinic and measured using the same methods [46]. As the serum-C-peptide upon diagnosis was of the same magnitude there seems to have been a slower loss of beta cell function in recent years.…”