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Item #8
C-Peptide
Improves Sensory Nerve Function in Type 1 Diabetes
Treatment
with C-peptide improves sensory nerve function in patients with type 1
diabetes.
Intensified
insulin treatment can slow the progression of various diabetic
complications, the authors explain, but nothing has been shown to
prevent the development of diabetic neuropathy.
Dr.
John Wahren and colleagues from Karolinska Institutet in Stockholm,
examined whether 3 months of C-peptide treatment could exert a
beneficial effect on early peripheral nerve function abnormalities in
26 patients with type 1 diabetes.
Sensory
and motor nerve conduction velocities, as well as compound muscle
action potential (CMAP) and sensory nerve action potential (SNAP)
amplitudes, were similar at baseline for the C-peptide-treated
patients and 20 placebo-treated patients. Metabolic control of
diabetes was also similar in the two groups, they report in the
February issue of Diabetes.
After
6 weeks of treatment, the C-peptide group showed a significant
increase in sensory nerve conduction velocity, which persisted as a 5%
improvement after 12 weeks, the authors report. This change resulted
in a restoration of sensory nerve conduction velocity to 80% of normal
values.
"The
significance of the 5% improvement in sensory nerve conduction
velocity stems from the fact that C-peptide could and, for the first
time in humans, did improve nerve conduction velocity in type 1
diabetic patients," Dr. Wahren told Reuters Health. "No
other treatment has been able to achieve that."
Motor
nerve conduction velocity also improved after 6 weeks of C-peptide
treatment, the report indicates, but this improvement had disappeared
by 12 weeks.
CMAP
did not change in either patient group, the researchers note, but SNAP
increased significantly in the placebo group. On the other hand,
vibration threshold decreased significantly (compared with placebo)
after 12 weeks of C-peptide treatment.
"C-peptide
is after all a biologically active peptide hormone of potential
importance for the therapy and/or the prevention of long-term
complications of type 1 diabetes," Dr. Wahren concluded.
"Molecular and cellular mechanisms of C-peptide action are
becoming increasingly understood, and supportive in vivo data from
patients and animals accumulate."
"Phase
2 B clinical trials to establish proof of this concept in patients
with diabetic neuropathy are now under way," Dr. Wahren added.
Diabetes
2003;52:536-541.
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