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C-peptide improves autonomic nerve function in IDDM patients

Summary

In order to determine the possible influence of C-peptide on nerve function, 12 insulin-dependent diabetic (IDDM) patients with symptoms of diabetic polyneuropathy were studied twice under euglycaemic conditions. Tests of autonomic nerve function (respiratory heart rate variability, acceleration and brake index during tilting), quantitative sensory threshold determinations, nerve conduction studies and clinical neurological examination were carried out before and during a 3-h i. v. infusion of either C-peptide (6 pmol · kg−1 · min−1) or physiological saline solution in a double-blind study. Plasma C-peptide concentrations increased from 0.11±0.02 to 1.73±0.04 nmol/l during C-peptide infusion. Clinical neurological examination quantitative sensory threshold evaluations and nerve conduction measurements failed to detect significant changes between C-peptide and saline study periods. Respiratory heart rate variability increased significantly from 13±1 to 20±2% during C-peptide infusion (p<0.001), reaching normal values in five of the subjects; control studies with saline infusion did not alter the heart rate variability (basal, 14±2; saline, 15±2%). A reduced brake index value was found in seven patients and increased significantly during the C-peptide infusion period (4.6±1.0 to 10.3±2.2%, p<0.05) but not during saline infusion (5.9±2 to 4.1±1.1%, NS). It is concluded that short-term (3-h) infusion of C-peptide in physiological amounts may improve autonomic nerve function in patients with IDDM.

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Abbreviations

IDDM:

Insulin-dependent diabetes mellitus

VT:

vibration perception threshold

CV:

conduction velocity

DL:

distal latency

CMAP:

compound action potential

S:

sensory amplitude

E/I ratio:

expiration/inspiration ratio

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Correspondence to J. Wahren.

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Johansson, B.L., Borg, K., Fernqvist-Forbes, E. et al. C-peptide improves autonomic nerve function in IDDM patients. Diabetologia 39, 687–695 (1996). https://doi.org/10.1007/BF00418540

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Keywords

  • Acceleration index
  • brake index
  • expiration-inspiration ratio
  • diabetic polyneuropathy
  • nerve conduction velocity
  • quantitative somatosensory thresholds
  • vibrametry