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C-Peptide Does Not Affect Ocular Blood Flow in Patients With Type 1 Diabetes

¹ Department of Clinical Pharmacology, Division of Ophthalmo-Pharmacology, Medical University of Vienna, Vienna, Austria
² Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
³ Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria
⁴ First Medical Department, Hanusch Hospital, Vienna, Austria
⁵ Center for Biomedical Engineering and Physics, Institute of Medical Physics, Medical University of Vienna, Vienna, Austria

Address correspondence and reprint requests to Prof. Dr. Leopold Schmetterer, Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. E-mail: leopold.schmetterer{at}meduniwien.ac.at

OBJECTIVE—The aim of the present study was to investigate the effect of intravenous C-peptide infusion on ocular blood flow in patients with type 1 diabetes under euglycemic conditions.

RESEARCH DESIGN AND METHODS—The study was performed in a randomized, placebo-controlled, double-masked, two-way, crossover design in 10 type 1 diabetic patients. C-peptide was intravenously administered at two different dosages (dosage 1: 25 pmol · kg^–1 · min^–1 bolus followed by 5 pmol · kg^–1 · min^–1 continuous infusion; dosage 2: six times higher than dosage 1), each for 60 min. Physiologic saline solution was used as a control for C-peptide on a different study day. On both study days, euglycemic clamps were performed. To assess retinal blood flow, laser Doppler velocimetry (blood flow velocities) and retinal vessel analyzer (vessels diameters) measurements were performed. Laser interferometric measurements of fundus pulsation were used to assess pulsatile choroidal blood flow. Blood velocities in the ophthalmic artery were measured using color Doppler imaging.

RESULTS—Eight patients (two female and six male) completed the study according to the protocol and without adverse events. One patient developed an anaphylactic reaction to C-peptide, which resolved without sequelae. The following results originate from the remaining eight subjects. Systemic hemodynamic parameters remained stable during both study days. Infusion of C-peptide did not affect any ocular hemodynamic parameter.

CONCLUSIONS—The data of the present study indicate that exogenous C-peptide exerts no effect on ocular hemodynamic parameters in type 1 diabetic patients under euglycemic conditions. The maximum detectable change in these parameters was <25%.

Abbreviations: CDI, color Doppler imaging • LDV, laser Doppler velocimetry

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