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C-Peptide Replacement Improves Early Diabetic Neuropathy

Jan 23, 2007

C-peptide improves sensory nerve function in type 1 diabetic patients with early-stage diabetic neuropathy. Dr. Karin Ekberg from the Karolinska Institute, Stockholm, Sweden stated that, "In contrast to what was previously the prevailing view, C-peptide is in fact a bioactive peptide and its effect may well be of importance for the maintenance of microvascular function." "Thus, C-peptide deficient patients, i.e., type 1 diabetes patients, should receive replacement of C-peptide probably already from the onset of the disease."

Dr. Ekberg and colleagues examined whether 6 months of treatment with C-peptide improved sensory nerve conduction velocity and other early signs of diabetic neuropathy in the lower extremities of 139 type 1 diabetic patients. They were randomized to low-dose C-peptide at 1.5 mg per day in four divided subcutaneous doses, to a 3-times higher dose, or placebo
At baseline, both sensory and motor nerve conduction velocities were significantly reduced compared with normal, the results indicate.

After 6 months of treatment, peak sensory nerve conduction velocities improved in the groups treated with low-dose or high-dose C-peptide, but not significantly compared with the control group, the researchers report.

However, significantly more patients treated with C-peptide (37%) than patients in the control group (19%) experienced a peak sensory nerve conduction velocity improvement of at least 1 meter/second, the investigators found.

Among patients with the least affected nerve conduction velocity at baseline, improvements in sensory nerve conduction velocity were significantly better among those treated with C-peptide, the researchers say.

Vibration perception threshold and neuropathy impairment assessment also improved in the C-peptide treatment group compared with the placebo group, but motor conduction velocities decreased in both groups during the study.

"C-peptide may be beneficial not only for nerve function, but also for the treatment and prevention of other diabetes-induced long-term complications of type 1 diabetes," Dr. Ekberg said. "There are clinical and pre-clinical data to indicate that C-peptide administration serves to ameliorate both functional and structural abnormalities in type 1 diabetic nephropathy."

The group plans "to continue the pharmaceutical development of C-peptide with phase III clinical studies in order to demonstrate the safety and efficacy of C-peptide replacement therapy for the treatment of diabetic peripheral neuropathy," Dr. Ekberg added. "Such studies will include a larger patient population and a treatment duration of at least 12 months."

Diabetes Care 2007;30:71-76.

Every minute across the world, 6 people die of diabetes… Either directly, or indirectly as the result of a complication. In total this disease is therefore the cause of almost 4 million deaths per year! Which is as many as those caused by AIDS. These are the figures put forward by the World Health Organization and the International Diabetes Federation (the IDF). It’s a genuine massacre which shows no sign of stopping.