Abstract
Low insulin in IDDM may depend on a defect insulin-release process and/or decreased number of beta cells. The aim of this study was to elucidate this question by analysing how the insulin secretion is related to actual blood glucose.
Patients and methods: Blood samples were drawn at day 0, 3,30,90,180,270,540 from 28 children who got IDDM at the age of 4-15 yrs (mean±SD 9.8±3.3). At 90, 270, 540 days a standardized breakfast was given and blood drawn after 0,30,60,90,120 min. C-peptide and blood glucose were determined.
Results: At diagnosis C-peptide was detectable in all children(range 0.05-0.58 pmol/ml;mean±SD 0.21±0.13). Fasting values reached a maximum at 3 months duration (0.04-0.58;0.21±0.11) as well as maximal C-peptide response (0.08-0.80;0.43±0.21). The cross-sectional correlation between blood glucose and C-peptide was weak, but in the individual patients the C-peptide response to breakfast was linearly correlated to the blood glucose increase still up to blood glucose values high above normal(at 3 months r=0.98,at 9 months r=0.97 and at 18 months r=0.98). Insulin secretion started at the same glucose but a certain C-peptide increase was associated with higher blood glucose at 18 than at 9 and 3 months.
Conclusion: The results indicate that the relationship between blood glucose and insulin secretion after breakfast is normal in children with IDDM. This suggests that the low insulin release mainly depends on too few beta cells.
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Ludvigsson, J. Insulin secretion is linearly proportional to blood glucose in insulin dependent diabetes (IDDM). Pediatr Res 18, 802 (1984). https://doi.org/10.1203/00006450-198408000-00068
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DOI: https://doi.org/10.1203/00006450-198408000-00068