Mo1579 Islet Autoantibodies and C-Peptide Levels in Patients With Diabetes and Symptoms of Gastroparesis

2016 ◽  
Vol 150 (4) ◽  
pp. S718 ◽  
Author(s):  
Carol Homko ◽  
Kevin P. May ◽  
Elias Siraj ◽  
Ajaykumar Rao ◽  
Henry P. Parkman ◽  
...  
Keyword(s):  
Islet Autoantibodies ◽  
C Peptide ◽  
Patients With Diabetes

scholarly journals Glycemia, Beta-Cell Function and Sensitivity to Insulin in Mildly to Critically Ill Covid-19 Patients

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 68 ◽  
Author(s):  
Ioannis Ilias ◽  
Aristidis Diamantopoulos ◽  
Maria Pratikaki ◽  
Efthymia Botoula ◽  
Edison Jahaj ◽  
...  
Keyword(s):  
Insulin Secretion ◽  
Beta Cell ◽  
Critically Ill ◽  
Beta Cell Function ◽  
Cell Function ◽  
Model Assessment ◽  
Secondary Diabetes ◽  
C Peptide ◽  
Number Of Patients ◽  
Patients With Diabetes

Background and objectives: Critically and non-critically ill patients with SARS-CoV-2 infection (Covid-19) may present with higher-than-expected glycemia, even in the absence of diabetes. With this study we aimed to assess glucose, glycemic gap (GlyG) and insulin secretion/sensitivity measures in patients with Covid-19. Materials and Methods: We studied, upon admission, 157 patients with Covid-19 (84: in wards and 73: in intensive care units; ICU); 135 had no history of diabetes. We measured blood glucose upon admission as well as glycated hemoglobin (A1c), plasma insulin and C-peptide. We calculated the GlyG and the Homeostasis Model Assessment 2 (HOMA2) estimates of steady state beta cell function (HOMA2%B) and insulin sensitivity (HOMA2%S). Statistical assessment was done with analysis or the Kruskal-Wallis test. Results: Compared to patients in the wards without diabetes, patients with diabetes in the wards, as well as patients in the ICU (without or with diabetes) had higher admission glycemia. The GlyG was significantly higher in patients without diabetes in the ICU compared to patients without diabetes in the wards, while HOMA2%B based on glucose and insulin was significantly higher in the ICU patients compared to patients in the wards. Of all the parameters, HOMA2%S based on C-peptide/glucose was higher in survivors (n = 133). Conclusions: In our series of patients with Covid-19, a substantial number of patients with and without diabetes had admission hyperglycemia and those who were critically ill may have had compromised insulin secretion and lowered sensitivity to insulin. These findings lend credence to reports of association between Covid-19 and hyperglycemia/secondary diabetes.

scholarly journals Positive correlation between fasting plasma glucagon and serum C-peptide in Japanese patients with diabetes

Heliyon ◽  
2019 ◽  
Vol 5 (5) ◽  
pp. e01715 ◽  
Author(s):  
Yoshiya Hosokawa ◽  
Junji Kozawa ◽  
Hitoshi Nishizawa ◽  
Dan Kawamori ◽  
Norikazu Maeda ◽  
...  
Keyword(s):  
Japanese Patients ◽  
Plasma Glucagon ◽  
C Peptide ◽  
Positive Correlation ◽  
Fasting Plasma ◽  
Patients With Diabetes

scholarly journals Highly specific radioimmunoassay for human insulin based on immune exclusion of all insulin precursors

1998 ◽  
Vol 44 (7) ◽  
pp. 1504-1513 ◽  
Author(s):  
Michelle Deberg ◽  
Paule Houssa ◽  
Bruce H Frank ◽  
Françoise Sodoyez-Goffaux ◽  
Jean-Claude Sodoyez
Keyword(s):  
Monoclonal Antibodies ◽  
Detection Limit ◽  
Affinity Constant ◽  
Serum Samples ◽  
C Peptide ◽  
Specific Radioimmunoassay ◽  
Coefficients Of Variation ◽  
Patients With Diabetes ◽  
A Chain ◽  
Immune Exclusion

Abstract We describe a rapid and simple insulin RIA in which proinsulin and conversion intermediates do not interfere. Three monoclonal antibodies (S1, S2, and S53) were selected for their specificity (directed, respectively, against the B10 region, the junction between A chain and C-peptide, and the junction between B chain and C-peptide), their affinity constant (∼1010 L/mol), and their interactive properties in mixture. S2 and S53 were able to bind simultaneously to the same proinsulin molecule, whereas neither could bind simultaneously with S1. Preincubation of serum samples with an excess of S2 resulted in capture of proinsulin and conversion intermediates modified at the junction between B chain and C-peptide into immune complexes that no longer reacted with S1. Similarly, preincubation with S53 prevented proinsulin and conversion intermediates modified at the junction between A chain and C-peptide from reacting with S1. Preincubation with an excess of both S2 and S53 left insulin as the sole reactant with S1. Thus, separation of insulin precursors from insulin by mutually exclusive antibodies is feasible, and on the basis of this new principle, a highly specific RIA for insulin was designed. The detection limit was 11 pmol/L, and the inter- and intraassay coefficients of variation were 11% and 5%, respectively. The potential of the assay for use in clinical studies was verified by application to serum samples from control subjects and patients with diabetes or insulinoma.

Plasma endothelin-1 and total insulin exposure in diabetes mellitus

1999 ◽  
Vol 97 (2) ◽  
pp. 149-156 ◽  
Author(s):  
Flemming WOLLESEN ◽  
Lars BERGLUND ◽  
Christian BERNE
Keyword(s):  
Type Ii Diabetes ◽  
Type I Diabetes ◽  
Insulin Dose ◽  
Albumin Excretion Rate ◽  
Wall Structure ◽  
Type I ◽  
Type Ii ◽  
C Peptide ◽  
Patients With Diabetes

Insulin stimulates endothelin-1 (ET-1) expression in a dose-response relationship, and ET-1 effects on vascular wall structure are similar to the long-term complications of diabetes. We therefore determined whether the plasma ET-1 concentration in patients with diabetes is associated with their total insulin exposure to see if plasma ET-1 might be a link between insulin exposure and long-term complications of diabetes. We studied 69 patients with Type I and 40 patients with Type II diabetes mellitus in equally tight glycaemic control for 2 years in a cross-sectional design. We measured basal and glucagon-stimulated plasma C-peptide, abdominal sagittal diameter, skinfold thickness, glomerular filtration rate, albumin excretion rate and standard clinical characteristics. Mean HbA1c was 6.4% in Type I and 6.3% in Type II diabetes. Patients with an albumin excretion rate > 300 μg/min were excluded. Adjusted mean plasma ET-1 was 4.11 (S.E.M. 0.39) pg/ml in 21 normal subjects, 3.47 (0.19) pg/ml in Type I diabetes and 4.84 (0.26) pg/ml in Type II diabetes (P = 0.0001). In all patients with measurable plasma C-peptide, plasma ET-1 was associated with basal plasma C-peptide (r = 0.5018, P < 0.0001), with stimulated plasma C-peptide (r = 0.5379, P < 0.0001), and with total daily insulin dose (r = 0.2219, P = 0.00851). Abdominal obesity, metabolic abnormalities, blood pressure and glomerular filtration rate were not associated with plasma ET-1, when corrected for C-peptide and daily insulin dose. Our study shows that the plasma concentration of ET-1 is closely associated with insulin secretion and insulin dose in patients with diabetes. Plasma ET-1 is higher in Type II diabetes than in Type I diabetes. Increased insulin exposure in patients with diabetes may have long-term effects on vascular wall structure through its stimulation of ET-1 expression.

Molecular mechanisms of action and physiological effects of the proinsulin C-peptide (a systematic review)

2020 ◽  
Vol 66 (3) ◽  
pp. 196-207
Author(s):  
O.N. Poteryaeva ◽  
I.F. Usynin
Keyword(s):  
Intracellular Signaling ◽  
Defense Mechanisms ◽  
Molecular Mechanisms ◽  
Therapeutic Potential ◽  
Experimental Models ◽  
Physiological Effects ◽  
C Peptide ◽  
Downstream Signaling ◽  
Blood Microcirculation ◽  
Patients With Diabetes

The C-peptide is a fragment of proinsulin, the cleavage of which forms active insulin. In recent years, new information has appeared on the physiological effects of the C-peptide, indicating its positive effect on many organs and tissues, including the kidneys, nervous system, heart, vascular endothelium and blood microcirculation. Studies on experimental models of diabetes mellitus in animals, as well as clinical trials in patients with diabetes, have shown that the C-peptide has an important regulatory effect on the early stages of functional and structural disorders caused by this disease. The C-peptide exhibits its effects through binding to a specific receptor on the cell membrane and activation of downstream signaling pathways. Intracellular signaling involves G-proteins and Ca2+-dependent pathways, resulting in activation and increased expression of endothelial nitric oxide synthase, Na+/K+-ATPase and important transcription factors involved in apoptosis, anti-inflammatory and other intracellular defense mechanisms. This review gives an idea of the C-peptide as a bioactive endogenous peptide that has its own biological activity and therapeutic potential.

scholarly journals International Comparison of C-Peptide Measurements

2007 ◽  
Vol 53 (4) ◽  
pp. 784-787 ◽  
Author(s):  
Hsiao-Mei Wiedmeyer ◽  
Kenneth S Polonsky ◽  
Gary L Myers ◽  
Randie R Little ◽  
Carla J Greenbaum ◽  
...  
Keyword(s):  
Interval Estimate ◽  
C Peptide ◽  
Method Effect ◽  
Patients With Diabetes ◽  
Heparin Plasma ◽  
Assay Methods ◽  
The Mean ◽  
The Impact ◽  
Single Laboratory ◽  
Comparability Of Results

Abstract Background: C-peptide measurement has been widely used as a marker of insulin secretion in patients with diabetes. We assessed the comparability of C-peptide results obtained with different methods and by different laboratories and determined whether C-peptide results could be harmonized by normalization with a WHO reference reagent or with plasma. Methods: We sent 16 different heparin plasma samples to 15 laboratories in 7 countries. The samples were analyzed with 10 different assay methods. A WHO C-peptide standard was also sent to each laboratory and used to determine the feasibility of normalizing results. To assess the impact of calibrator matrix on the comparability of results, we also used the mean results of all laboratories for 4 of the samples to normalize the remaining sample results. Results: Between-laboratory variability increased with increasing C-peptide concentrations. Normalization of results with WHO reference reagents did not improve comparability, but normalization with samples significantly improved comparability among laboratories and methods. The 95% confidence interval estimate for the SD for the lab/method effect (0.0–0.061) using sample-normalized values did not overlap with the 95% CI estimate with the raw data (0.090–0.225). Conclusions: C-peptide results generated by different methods and different laboratories do not always agree, especially at higher concentrations of C-peptide. These data support the concept of using a single laboratory for multisite studies and support efforts to harmonize C-peptide measurements by use of calibrators prepared in the sample matrix.

scholarly journals Immunological Hypoglycemia Associated with Insulin Antibodies Induced by Exogenous Insulin in 11 Chinese Patients with Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Heng Quan ◽  
Huiwen Tan ◽  
Qianrui Li ◽  
Jianwei Li ◽  
Sheyu Li
Keyword(s):  
Lifestyle Modification ◽  
Insulin Antibodies ◽  
Chinese Patients ◽  
Hypoglycemic Agents ◽  
Immunoreactive Insulin ◽  
Exogenous Insulin ◽  
Oral Hypoglycemic Agents ◽  
C Peptide ◽  
Patients With Diabetes ◽  
Insulin Use

Aims. To investigate the characteristics of immunological hypoglycemia associated with insulin antibodies (IAbs) induced by exogenous insulin in Chinese patients with diabetes.Methods. The clinical data of patients with immunological hypoglycemia due to IAbs were retrospectively analyzed by screening patients with diabetes discharged from West China Hospital from 2007 to 2013.Results. A total of 11 patients (eight men and three women) were identified. Insulin-C-peptide separation was found in all patients via insulin and C-peptide release test. Previous insulin use was ceased after admission and was switched to oral hypoglycemic agents (OHAs) (8/11), lifestyle modification only (2/11), or regular human insulin (1/11). Hypoglycemia was ameliorated after a median of 20 days (interquartile range [IQR], 11–40), while IAbs turned negative after a median of 17 months (IQR, 4–19), and serum immunoreactive insulin (IRI) levels dropped substantially after a median of 22 months (IQR, 9–32) in these cases.Conclusions. In insulin-treated patients with unexpected and refractory hypoglycemia even after insulin therapy was gradually reduced or even withdrawn, IAbs induced by exogenous insulin should be considered, and insulin withdrawal might be promptly needed. The course of immunological hypoglycemia was benign and self-limited.

scholarly journals The Ratio of Estimated Average Glucose to Fasting Plasma Glucose Level Is Superior to Glycated Albumin, Hemoglobin A1c, Fructosamine, and GA/A1c Ratio for Assessingβ-Cell Function in Childhood Diabetes

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Ji Eun Lee ◽  
Ji Woo Lee ◽  
Tatsuyoshi Fujii ◽  
Noriyoshi Fujii ◽  
Jong Weon Choi
Keyword(s):  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Cell Function ◽  
Glycated Albumin ◽  
Model Assessment ◽  
C Peptide ◽  
Fasting Plasma ◽  
Glucose Ratio ◽  
Patients With Diabetes ◽  
Average Glucose

Objective. This study investigated the use of the estimated average glucose to fasting plasma glucose ratio (eAG/fPG ratio) to screen forβ-cell function in pediatric diabetes.Methods. Glycated hemoglobin (HbA1c), glycated albumin (GA), fructosamine, insulin, and C-peptide levels were measured. The ratio of GA to HbA1c (GA/A1c ratio) was calculated, and the homeostasis model assessment ofβ-cell function (HOMA-β) was determined.Results. Median values of C-peptide, insulin, and HOMA-βlevels were significantly higher in patients with an increased eAG/fPG ratio than in those with a decreased eAG/fPG ratio. C-peptide and HOMA-βlevels were more closely correlated with the eAG/fPG ratio than with GA, HbA1c, the GA/A1c ratio, and fructosamine. In contrast, body mass index was significantly associated with GA, GA/A1c ratio, and fructosamine, but not with the eAG/fPG ratio and HbA1c levels. To test the diagnostic accuracies of the eAG/fPG ratio for identifying HOMA-β> 30.0% in patients with type 2 diabetes, the area under the ROC curve of the eAG/fPG ratio was significantly larger than that of the GA/A1c ratio [0.877 (95% CI, 0.780–0.942) versus 0.775 (95% CI, 0.664–0.865),P=0.039].Conclusions. A measurement of the eAG/fPG ratio may provide helpful information for assessingβ-cell function in pediatric patients with diabetes.

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