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December 1980, Vol 134, No. 12 >
Article | December 1980

Urine C-peptide, β-Cell Function, and Insulin Requirement FREE

Elizabeth B. Rappaport, MD; Robert A. Ulstrom, MD; Donnell D. Etzwiler, MD; Daniel Fife, MD; Bo E. Hedlund, PhD; Michael W. Steffes, MD, PhD
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Am J Dis Child. 1980;134(12):1129-1133. doi:10.1001/archpedi.1980.02130240013006.
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• Urinary C-peptide excretion was investigated as a method for monitoring β-cell function in diabetic patients and for studying the contribution of endogenous insulin production to diabetic control. Control subjects had variations in serum and urine C-peptide immunoreactivity that correlated with basal and meal-related insulin secretion. In a group of well-controlled juvenile diabetic patients, those receiving high doses of insulin had low or negligible C-peptide excretion, whereas most patients with low exogenous insulin requirements had near-normal urinary C-peptide excretion. Patients treated for diabetic ketoacidosis had recovery of β-cell function as measured by C-peptide immunoreactivity in serial urine specimens. Thus, measurement of urinary C-peptide excretion is a simple technique that may be useful in assessing endogenous insulin production in juvenile diabetic patients.

(Am J Dis Child 134:1129-1133, 1980)

REFERENCES

1 +
Block MB, Rosenfield RL, Mako ME, et al:  Sequential changes in β-cell function in insulin-treated diabetic patients assessed by C-peptide immunoreactivity . N Engl J Med 288:1144-1148, 1973;.
2 +
Faber OK, Binder C:  β-Cell function and blood glucose control in insulin-dependent diabetics within the first month of insulin treatment . Diabetologia 13:263-268, 1977;.
3 +
Grajwer LA, Pildes RS, Horwitz DL, et al:  Control of juvenile diabetes mellitus and its relationship to endogenous insulin secretion as measured by C-peptide immunoreactivity . J Pediatr 90:42-48, 1977;.
4 +
Heding LG, Rasmussen SM:  Human C-peptide in normal and diabetic subjects . Diabetologia 11:201-206, 1975;.
5 +
Ludvigsson J, Heding LG:  C-peptide in children with juvenile diabetes: A preliminary report . Diabetologia 12:627-630, 1976;.
6 +
Ludvigsson J, Heding LG, Larsson Y, et al:  C-peptide in juvenile diabetics beyond the postinitial remission period . Acta Paediatr Scand 66:177-184, 1977;.
7 +
Madsbad S, Faber OK, Binder C, et al:  Prevalence of residual β-cell function in insulin-dependent diabetics in relation to age at onset and duration of diabetes . Diabetes 27:262-264, 1978;.
8 +
Horwitz DL, Rubenstein AH, Katz AI:  Quantitation of human pancreatic β-cell function by immunoassay of C-peptide in urine . Diabetes 26:30-35, 1977;.
9 +
Horwitz DL, Rubenstein AH, Mako ME, et al:  C-peptide in conditions other than diabetes mellitus . Diabetes 27:267-271, 1978;.
10 +
Fabiny DL, Ertingshausen G:  Automated reaction rate method for determination of creatinine with the centrifichem . Clin Chem 17:696-700, 1971;.
11 +
Trivelli LA, Ranney HM, Lai HT:  Hemoglobin components in patients with diabetes mellitus . N Engl J Med 284:353-357, 1971;.
12 +
Gabbay KG, Hasty K, Breslow JL, et al:  Glycosylated hemoglobins and long-term blood glucose control in diabetes mellitus . J Clin Endocrinol Metab 44:859-864, 1977;.
13 +
Nakagawa S, Nakayama H, Saski T, et al:  A simple method for the determination of serum free insulin levels in insulin treated patients . Diabetes 22:590-600, 1973;.
14 +
Belmonte MM, Sarkozy E, Harpur ER:  Urine sugar determination by the two-drop Clinitest method . Diabetes 16:557-559, 1967;.
15 +
Morgan CR, Lazarow A:  Immunoassay of insulin: Two antibody system . Diabetes 12:115-126, 1963;.
16 +
Papadopoulou ZL, Tina LU, Sandler P, et al:  Size and function of the kidneys , in Johnson TR, Moore WM, Jeffries JE (eds): Children Are Different: Developmental Physiology . Columbus, Ohio, Ross Laboratories, 1978;, p 99.
17 +
Jackson RL, Guthrie RA:  The child with diabetes . Mo Med 69:351-358, 1972;.
18 +
Kuzuya H, Horwitz DL, Stelling M, et al:  Blood sugar control in insulin requiring diabetics: Relationship of exogenous and endogenous insulin, abstracted . Clin Res 22:618A, 1974;.
19 +
Jackson RL, Hewett JE, Hess RL, et al:  Objective criteria for classifying degree of control in children with insulin dependent diabetes , abstract No. 54. Diabetes 27:444, 1978;.
20 +
Turner RC, McCarthy ST, Holman RR, et al:  β-Cell function improved by supplementing basal insulin secretion in mild diabetes . Br Med J 1:1252-1254, 1976;.
21 +
Mirouze J, Selam JL, Pham TC, et al:  Sustained insulin-induced remissions of juvenile diabetes by means of an external artificial pancreas . Diabetologia 14:223-227, 1978;.
22 +
Genuth SM:  Insulin secretion in obesity and diabetes: An illustrative case . Ann Intern Med 87:714-716, 1977;.
23 +
Jackson RL, Murthy DYN:  Importance of early insulin treatment and good regulation of children with diabetes . Mo Med 71:173-176, 1974;.
24 +
 New insulin-delivery systems for diabetics , editorial. Lancet 1:1275-1277, 1979;.
25 +
Pickup JC, Keen H, Parsons JA, et al:  Continuous subcutaneous insulin infusion: Improved blood-glucose and intermediary-metabolite control in diabetics . Lancet 1:1255-1257, 1979;.
26 +
Tamborlane WV, Sherwin RS, Genel M, et al:  Restoration of normal lipid and aminoacid metabolism in diabetic patients treated with a portable insulin-infusion pump . Lancet 1:1258-1261, 1979;.
27 +
Deckert T, Lørup B:  Regulation of brittle diabetics by a preplanned insulin infusion programme . Diabetologia 12:573-579, 1976;.

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References

1 +
Block MB, Rosenfield RL, Mako ME, et al:  Sequential changes in β-cell function in insulin-treated diabetic patients assessed by C-peptide immunoreactivity . N Engl J Med 288:1144-1148, 1973;.
2 +
Faber OK, Binder C:  β-Cell function and blood glucose control in insulin-dependent diabetics within the first month of insulin treatment . Diabetologia 13:263-268, 1977;.
3 +
Grajwer LA, Pildes RS, Horwitz DL, et al:  Control of juvenile diabetes mellitus and its relationship to endogenous insulin secretion as measured by C-peptide immunoreactivity . J Pediatr 90:42-48, 1977;.
4 +
Heding LG, Rasmussen SM:  Human C-peptide in normal and diabetic subjects . Diabetologia 11:201-206, 1975;.
5 +
Ludvigsson J, Heding LG:  C-peptide in children with juvenile diabetes: A preliminary report . Diabetologia 12:627-630, 1976;.
6 +
Ludvigsson J, Heding LG, Larsson Y, et al:  C-peptide in juvenile diabetics beyond the postinitial remission period . Acta Paediatr Scand 66:177-184, 1977;.
7 +
Madsbad S, Faber OK, Binder C, et al:  Prevalence of residual β-cell function in insulin-dependent diabetics in relation to age at onset and duration of diabetes . Diabetes 27:262-264, 1978;.
8 +
Horwitz DL, Rubenstein AH, Katz AI:  Quantitation of human pancreatic β-cell function by immunoassay of C-peptide in urine . Diabetes 26:30-35, 1977;.
9 +
Horwitz DL, Rubenstein AH, Mako ME, et al:  C-peptide in conditions other than diabetes mellitus . Diabetes 27:267-271, 1978;.
10 +
Fabiny DL, Ertingshausen G:  Automated reaction rate method for determination of creatinine with the centrifichem . Clin Chem 17:696-700, 1971;.
11 +
Trivelli LA, Ranney HM, Lai HT:  Hemoglobin components in patients with diabetes mellitus . N Engl J Med 284:353-357, 1971;.
12 +
Gabbay KG, Hasty K, Breslow JL, et al:  Glycosylated hemoglobins and long-term blood glucose control in diabetes mellitus . J Clin Endocrinol Metab 44:859-864, 1977;.
13 +
Nakagawa S, Nakayama H, Saski T, et al:  A simple method for the determination of serum free insulin levels in insulin treated patients . Diabetes 22:590-600, 1973;.
14 +
Belmonte MM, Sarkozy E, Harpur ER:  Urine sugar determination by the two-drop Clinitest method . Diabetes 16:557-559, 1967;.
15 +
Morgan CR, Lazarow A:  Immunoassay of insulin: Two antibody system . Diabetes 12:115-126, 1963;.
16 +
Papadopoulou ZL, Tina LU, Sandler P, et al:  Size and function of the kidneys , in Johnson TR, Moore WM, Jeffries JE (eds): Children Are Different: Developmental Physiology . Columbus, Ohio, Ross Laboratories, 1978;, p 99.
17 +
Jackson RL, Guthrie RA:  The child with diabetes . Mo Med 69:351-358, 1972;.
18 +
Kuzuya H, Horwitz DL, Stelling M, et al:  Blood sugar control in insulin requiring diabetics: Relationship of exogenous and endogenous insulin, abstracted . Clin Res 22:618A, 1974;.
19 +
Jackson RL, Hewett JE, Hess RL, et al:  Objective criteria for classifying degree of control in children with insulin dependent diabetes , abstract No. 54. Diabetes 27:444, 1978;.
20 +
Turner RC, McCarthy ST, Holman RR, et al:  β-Cell function improved by supplementing basal insulin secretion in mild diabetes . Br Med J 1:1252-1254, 1976;.
21 +
Mirouze J, Selam JL, Pham TC, et al:  Sustained insulin-induced remissions of juvenile diabetes by means of an external artificial pancreas . Diabetologia 14:223-227, 1978;.
22 +
Genuth SM:  Insulin secretion in obesity and diabetes: An illustrative case . Ann Intern Med 87:714-716, 1977;.
23 +
Jackson RL, Murthy DYN:  Importance of early insulin treatment and good regulation of children with diabetes . Mo Med 71:173-176, 1974;.
24 +
 New insulin-delivery systems for diabetics , editorial. Lancet 1:1275-1277, 1979;.
25 +
Pickup JC, Keen H, Parsons JA, et al:  Continuous subcutaneous insulin infusion: Improved blood-glucose and intermediary-metabolite control in diabetics . Lancet 1:1255-1257, 1979;.
26 +
Tamborlane WV, Sherwin RS, Genel M, et al:  Restoration of normal lipid and aminoacid metabolism in diabetic patients treated with a portable insulin-infusion pump . Lancet 1:1258-1261, 1979;.
27 +
Deckert T, Lørup B:  Regulation of brittle diabetics by a preplanned insulin infusion programme . Diabetologia 12:573-579, 1976;.

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