Residual C-peptide excretion is associated with a better long-term glycemic control and slower progress of retinopathy in type I (insulin-dependent) diabetes mellitus

S. Sjöberg, M. Gjötterberg, Lars Berglund, E. Möller, J. Östman

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Abstract

We evaluated the progression of microangiopathic lesions in 22 type I diabetic patients with residual C-peptide excretion and in 22 type I diabetic patients matched for age at onset and disease duration without residual C-peptide excretion. We also wished to elucidate whether certain HLA-DR phenotypes were associated with preserved insulin secretory activity and/or microvascular lesions. The two groups of patients were investigated in 1984 and 1985. In the previous report, we observed less frequent signs of early microangiopathic lesions in association with a lower HbA1c in the group with a detectable urinary C-peptide excretion. The HbA1c level has been measured regularly (7-12 times) since the initial investigation; the mean value was lower in the patient group with residual C-peptide excretion than in the non-C-peptide group (p = 0.01). Nine of the patients in the group without urinary C-peptide excretion had increased severity of retinopathy, but only two in the group with urinary C-peptide excretion (p = 0.04) had progression of retinopathy. Incipient and/or manifest albuminuria was observed in six of the nonexcretor group and one of the C-peptide excretors. Four of the patients were receiving antihypertensive treatment and three others had a diastolic blood pressure ≥ 90 mmHg in the non-C-peptide excretor group as compared with one with a pressure ≥ 90 mmHg in the C-peptide excretor group. All 16 patients with moderate to advanced nonproliferative background retinopathy and/or incipient albuminuria had HLA-DR 3 4, 3 x, or 4 x antigens, as compared with 20 of 28 patients with few if any signs of microangiopathy. We conclude that urinary C-peptide excretion together with regular measurements of HbA1c may be used for prognostic evaluation of the increase in severity of retinopathy in groups of patients with type I diabetes.

Original languageEnglish (US)
Pages (from-to)18-22
Number of pages5
JournalJournal of Diabetic Complications
Volume5
Issue number1
DOIs
StatePublished - 1991
Externally publishedYes

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C-Peptide
Type 1 Diabetes Mellitus
Albuminuria
HLA-DR Antigens
Blood Pressure
Peptides
Age of Onset
Antihypertensive Agents
Insulin
Phenotype
Antigens
Pressure

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Residual C-peptide excretion is associated with a better long-term glycemic control and slower progress of retinopathy in type I (insulin-dependent) diabetes mellitus. / Sjöberg, S.; Gjötterberg, M.; Berglund, Lars; Möller, E.; Östman, J.

In: Journal of Diabetic Complications, Vol. 5, No. 1, 1991, p. 18-22.

Research output: Contribution to journalArticle

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abstract = "We evaluated the progression of microangiopathic lesions in 22 type I diabetic patients with residual C-peptide excretion and in 22 type I diabetic patients matched for age at onset and disease duration without residual C-peptide excretion. We also wished to elucidate whether certain HLA-DR phenotypes were associated with preserved insulin secretory activity and/or microvascular lesions. The two groups of patients were investigated in 1984 and 1985. In the previous report, we observed less frequent signs of early microangiopathic lesions in association with a lower HbA1c in the group with a detectable urinary C-peptide excretion. The HbA1c level has been measured regularly (7-12 times) since the initial investigation; the mean value was lower in the patient group with residual C-peptide excretion than in the non-C-peptide group (p = 0.01). Nine of the patients in the group without urinary C-peptide excretion had increased severity of retinopathy, but only two in the group with urinary C-peptide excretion (p = 0.04) had progression of retinopathy. Incipient and/or manifest albuminuria was observed in six of the nonexcretor group and one of the C-peptide excretors. Four of the patients were receiving antihypertensive treatment and three others had a diastolic blood pressure ≥ 90 mmHg in the non-C-peptide excretor group as compared with one with a pressure ≥ 90 mmHg in the C-peptide excretor group. All 16 patients with moderate to advanced nonproliferative background retinopathy and/or incipient albuminuria had HLA-DR 3 4, 3 x, or 4 x antigens, as compared with 20 of 28 patients with few if any signs of microangiopathy. We conclude that urinary C-peptide excretion together with regular measurements of HbA1c may be used for prognostic evaluation of the increase in severity of retinopathy in groups of patients with type I diabetes.",
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