Proinsulin Secretion During the First 3 Years After Diagnosis in Diabetic Patients With and Without Islet Cell Antibodies

A Gottsäter; D R Owens; S Luzio; G Sundkvist

doi:10.2337/diacare.19.6.659

Short Reports

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

Diabetes Care 1996 Jun; 19(6): 659-662. https://doi.org/10.2337/diacare.19.6.659

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.