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Amelioration of sensory nerve dysfunction by C-Peptide in patients with type 1 diabetes.
Diabetes 2003; 52(2):536-41D

Abstract

Studies have demonstrated that proinsulin C-peptide stimulates the activities of Na(+),K(+)-ATPase and endothelial nitric oxide synthase, both of which are enzyme systems of importance for nerve function and known to be deficient in type 1 diabetes. The aim of this randomized double-blind placebo-controlled study was to investigate whether C-peptide replacement improves nerve function in patients with type 1 diabetes. Forty-nine patients without symptoms of peripheral neuropathy were randomized to either 3 months of treatment with C-peptide (600 nmol/24 h, four doses s.c.) or placebo. Forty-six patients (15 women and 31 men, aged 29 years, diabetes duration 10 years, and HbA(1c) 7.0%) completed the study. Neurological and neurophysiological measurements were performed before and after 6 and 12 weeks of treatment. At baseline the patients showed reduced nerve conduction velocities in the sural nerve (sensory nerve conduction velocity [SCV]: 50.9 +/- 0.70 vs. 54.2 +/- 1.2 m/s, P < 0.05) and peroneal nerve (motor nerve conduction velocity: 45.7 +/- 0.55 vs. 53.5 +/- 1.1 m/s, P < 0.001) compared with age-, height-, and sex-matched control subjects. In the C-peptide treated group there was a significant improvement in SCV amounting to 2.7 +/- 0.85 m/s (P < 0.05 compared with placebo) after 3 months of treatment, representing 80% correction of the initial reduction in SCV. The change in SCV was accompanied by an improvement in vibration perception in the patients receiving C-peptide (P < 0.05 compared with placebo), whereas no significant change was detectable in cold or heat perception. In conclusion, C-peptide administered for 3 months as replacement therapy to patients with early signs of diabetic neuropathy ameliorates nerve dysfunction.

Authors+Show Affiliations

Department of Surgical Sciences, Section of Clinical Physiology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12540632

Citation

Ekberg, Karin, et al. "Amelioration of Sensory Nerve Dysfunction By C-Peptide in Patients With Type 1 Diabetes." Diabetes, vol. 52, no. 2, 2003, pp. 536-41.
Ekberg K, Brismar T, Johansson BL, et al. Amelioration of sensory nerve dysfunction by C-Peptide in patients with type 1 diabetes. Diabetes. 2003;52(2):536-41.
Ekberg, K., Brismar, T., Johansson, B. L., Jonsson, B., Lindström, P., & Wahren, J. (2003). Amelioration of sensory nerve dysfunction by C-Peptide in patients with type 1 diabetes. Diabetes, 52(2), pp. 536-41.
Ekberg K, et al. Amelioration of Sensory Nerve Dysfunction By C-Peptide in Patients With Type 1 Diabetes. Diabetes. 2003;52(2):536-41. PubMed PMID: 12540632.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Amelioration of sensory nerve dysfunction by C-Peptide in patients with type 1 diabetes. AU - Ekberg,Karin, AU - Brismar,Tom, AU - Johansson,Bo-Lennart, AU - Jonsson,Björn, AU - Lindström,Per, AU - Wahren,John, PY - 2003/1/24/pubmed PY - 2003/4/8/medline PY - 2003/1/24/entrez SP - 536 EP - 41 JF - Diabetes JO - Diabetes VL - 52 IS - 2 N2 - Studies have demonstrated that proinsulin C-peptide stimulates the activities of Na(+),K(+)-ATPase and endothelial nitric oxide synthase, both of which are enzyme systems of importance for nerve function and known to be deficient in type 1 diabetes. The aim of this randomized double-blind placebo-controlled study was to investigate whether C-peptide replacement improves nerve function in patients with type 1 diabetes. Forty-nine patients without symptoms of peripheral neuropathy were randomized to either 3 months of treatment with C-peptide (600 nmol/24 h, four doses s.c.) or placebo. Forty-six patients (15 women and 31 men, aged 29 years, diabetes duration 10 years, and HbA(1c) 7.0%) completed the study. Neurological and neurophysiological measurements were performed before and after 6 and 12 weeks of treatment. At baseline the patients showed reduced nerve conduction velocities in the sural nerve (sensory nerve conduction velocity [SCV]: 50.9 +/- 0.70 vs. 54.2 +/- 1.2 m/s, P < 0.05) and peroneal nerve (motor nerve conduction velocity: 45.7 +/- 0.55 vs. 53.5 +/- 1.1 m/s, P < 0.001) compared with age-, height-, and sex-matched control subjects. In the C-peptide treated group there was a significant improvement in SCV amounting to 2.7 +/- 0.85 m/s (P < 0.05 compared with placebo) after 3 months of treatment, representing 80% correction of the initial reduction in SCV. The change in SCV was accompanied by an improvement in vibration perception in the patients receiving C-peptide (P < 0.05 compared with placebo), whereas no significant change was detectable in cold or heat perception. In conclusion, C-peptide administered for 3 months as replacement therapy to patients with early signs of diabetic neuropathy ameliorates nerve dysfunction. SN - 0012-1797 UR - https://www.unboundmedicine.com/medline/citation/12540632/Amelioration_of_sensory_nerve_dysfunction_by_C_Peptide_in_patients_with_type_1_diabetes_ L2 - http://diabetes.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=12540632 DB - PRIME DP - Unbound Medicine ER -