Proinsulin Secretion During the First 3 Years After Diagnosis in Diabetic Patients With and Without Islet Cell Antibodies
- A Gottsäter, MD, PHD,
- D R Owens, MRCP, MD,
- S Luzio, PHD and
- G Sundkvist, MD, PHD
- Departments of Vascular and Renal Diseases, University of Lund, University Hospital MAS Malmö, Sweden
- Departments of Endocrinology, University of Lund, University Hospital MAS Malmö, Sweden
- Department of Medicine, University Hospital of Wales Cardiff, U.K.
- Address correspondence and reprint requests to Dr. Anders Gottsäter, Department of Vascular and Renal Diseases, University of Lund, University Hospital MAS, S-205 02 Malmö, Sweden
Abstract
OBJECTIVE To evaluate proinsulin secretion in different types of NIDDM.
RESEARCH DESIGN AND METHODS Proinsulin and insulin were evaluated at diagnosis of diabetes and 3 years later (fasting and after stimulation with intravenous glucose and glucagon) in 10 NIDDM patients without islet cell antibodies (ICAs) at diagnosis (age 52 ± 4 years), 11 NIDDM patients with ICAs at diagnosis (age 50 ± 5 years), and 21 healthy control subjects (age 53 ± 4 years).
RESULTS At diagnosis, fasting proinsulin was higher in NIDDM patients without ICAs than in control subjects (39.6 ± 10.0 vs. 12.8 ± 1.6 pmol/l, P < 0.01). Proinsulin response to intravenous glucose decreased in NIDDM patients with ICAs (from 35.6 ± 6.2 to 13.5 ± 5.4 pmol/l, P < 0.05), but remained unchanged in those without ICAs. At 3 years after diagnosis, fasting proinsulin (10.0 ± 3.7 vs. 59.1 ± 17.0 pmol/l) and proinsulin responses to intravenous glucose (13.5 ± 5.4 vs. 103.9 ± 35.1 pmol/l) and to intravenous glucagon (7.4 ± 3.9 vs. 36.0 ± 7.7 pmol/l) were much lower (P < 0.01) in NIDDM patients with ICAs than in those without ICAs.
CONCLUSIONS After diagnosis of diabetes, proinsulin secretion decreases significantly in NIDDM patients with ICAs and remains constant in those without.
- Received April 4, 1995.
- Revision received February 6, 1996.
- Accepted February 6, 1996.
- Copyright © 1996 by the American Diabetes Association
