c-peptide and Pancreatic-Diseases

c-peptide has been researched along with Pancreatic-Diseases* in 35 studies

Trials

2 trial(s) available for c-peptide and Pancreatic-Diseases

ArticleYear
Relative hyperproinsulinemia as a sign of islet dysfunction in women with impaired glucose tolerance.
    The Journal of clinical endocrinology and metabolism, 1999, Volume: 84, Issue:6

    Proinsulin release is increased relative to insulin secretion in subjects with type 2 diabetes, indicative of islet dysfunction. However, it has not been conclusively shown whether there is an increased relative proinsulin release in subjects with impaired glucose tolerance (IGT), i.e. whether it precedes the development of diabetes. We therefore determined the proinsulin to insulin ratios in the fasting state and after acute stimulation of insulin secretion in 23 postmenopausal women, aged 61-62 yr (mean +/- SD, 61.7 +/- 0.5 yr). Ten women had normal glucose tolerance (NGT), and 13 had IGT. The groups were matched for insulin sensitivity and did not differ in body mass index. Proinsulin and insulin secretion were measured after arginine stimulation (5 g, i.v.) at three glucose levels (fasting, 14 mmol/L, and >25 mmol/L), and the acute insulin (AIR(arg)) and proinsulin responses (APIR(arg)) were calculated as the mean 2-5 min postload increase. At fasting glucose, levels of insulin, proinsulin, or the proinsulin/insulin ratio (13.6 +/- 5.0% vs. 11.1 +/- 2.7%; P = NS) did not differ between NGT and IGT. Although the AIR(arg) values were decreased in the IGT group at all glucose levels (P < 0.05), the absolute proinsulin levels and the APIRs(arg) were similar between IGT and NGT women. Therefore, the IGT women had higher proinsulin/insulin ratios at 14 mmol/L (10.7 +/- 4.4% vs. 6.4 +/- 1.8%; P = 0.006) and more than 25 mmol/L glucose (11.4 +/- 5.2% vs. 6.7 +/- 2.1%; P = 0.007). The IGT group had increased APIR(arg)/AIR(arg) at fasting (2.2 +/- 1.4% vs. 1.3 +/- 0.6%; P = 0.047) and more than 25 mmol/L glucose (3.5 +/- 1.6% vs. 2.3 +/- 0.7%; P = 0.037). We conclude that women with IGT exhibit increased relative proinsulin secretion, suggesting a defect in the intracellular proinsulin processing before diabetes develops.

    Topics: Arginine; Biomarkers; Blood Glucose; C-Peptide; Female; Glucose Tolerance Test; Humans; Insulin; Islets of Langerhans; Middle Aged; Pancreatic Diseases; Proinsulin

1999
Tumor and serum levels of proinsulin and insulin in insulinoma patients.
    Endocrine journal, 1993, Volume: 40, Issue:2

    The amounts of immunoreactive proinsulin (IRP), immunoreactive insulin (IRI), and C-peptidelike immunoreactivity (CPR) in six insulinomas and one nesidioblastosis lesion were determined together with those in the surrounding pancreatic tissue. Four non-insulinoma and nondiabetic human pancreases were used as the control. The IRP in the seven tumors ranged from 5.85 micrograms/g to 65.45 micrograms/g (mean +/- SEM, 28.70 +/- 8.01 micrograms/g), while the IRP in the surrounding pancreatic tissue ranged from 2.08 micrograms/g to 11.71 micrograms/g (5.32 +/- 1.76 micrograms/g). Control pancreases had an IRP content of 12.01 +/- 2.36 micrograms/g. The IRI in the seven tumors ranged from 4.02 U/g to 47.97 U/g (14.40 +/- 6.35 U/g), while that in the surrounding pancreatic tissue ranged from 0.28 U/g to 3.64 U/g (2.32 +/- 0.63 U/g). Mean tumor CPR was 206.84 +/- 81.6 micrograms/g and it was 29.16 +/- 9.15 micrograms/g in the surrounding pancreatic tissue. The molar ratio of the IRP to IRI content was 6.83 +/- 1.95% for tumor tissue and 6.24 +/- 2.18% for the surrounding pancreatic tissue. These levels were similar to the ratio in the control pancreases (7.67 +/- 1.88%), in contrast to the higher serum IRP/IRI ratio in the tumor patients.

    Topics: Adult; Aged; Aged, 80 and over; C-Peptide; Female; Humans; Insulin; Insulinoma; Male; Middle Aged; Pancreas; Pancreatic Diseases; Pancreatic Neoplasms; Proinsulin

1993

Other Studies

33 other study(ies) available for c-peptide and Pancreatic-Diseases

ArticleYear
Pancreatic fat is related to the longitudinal decrease in the increment of C-peptide in glucagon stimulation test in type 2 diabetes patients.
    Journal of diabetes investigation, 2020, Volume: 11, Issue:1

    The relationship between pancreatic fatty infiltration and diabetes is widely known, whereas the causal relationship is not clear. Furthermore, it is uncertain whether pathogenesis of pancreatic fat is similar to that of liver fat. We aimed to clarify the contribution of this type of fat to glucose metabolism in type 2 diabetes patients by cross-sectional and longitudinal analyses.. A total of 56 patients with type 2 diabetes who had been hospitalized twice were analyzed. We evaluated the mean computed tomography values of the pancreas (P), liver (L) and spleen (S). Lower computed tomography values indicate a greater fat content. We defined indices of pancreatic or liver fat content as the differences between P or L and S. We assessed the associations among fat content for the two organs (P-S, L-S) and clinical parameters at the first hospitalization, and then analyzed the associations between these fat contents and changes in glycometabolic markers (the second data values minus the first).. In the cross-sectional study, P-S negatively correlated with the increment of C-peptide in the glucagon stimulation test (r = -0.71, P < 0.0001) and body mass index (r = -0.28, P = 0.034). L-S negatively correlated with homeostasis model assessment of insulin resistance (r = -0.73, P < 0.0001), body mass index (r = -0.62, P < 0.0001) and some other obesity-related indicators, but not with the increment of C-peptide in the glucagon stimulation test. In the longitudinal study, P-S positively correlated with the change of the increment of C-peptide in the glucagon stimulation test (r = 0.49, P = 0.021).. In type 2 diabetes patients, pancreatic fat was less associated with obesity-related indicators than liver fat, but was more strongly associated with the longitudinal decrease in endogenous insulin-secreting capacity.

    Topics: Adipose Tissue; Aged; Biomarkers; C-Peptide; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Fatty Liver; Female; Follow-Up Studies; Gastrointestinal Agents; Glucagon; Glucose Tolerance Test; Humans; Longitudinal Studies; Male; Pancreatic Diseases; Prognosis

2020
Risk Factors Associated With Progression Toward Endocrine Insufficiency in Chronic Pancreatitis.
    Pancreas, 2019, Volume: 48, Issue:9

    Little data exist describing the change over time in islet function and glycemic control in patients with chronic pancreatitis (CP).. In 325 CP patients who underwent 2 mixed meal tolerance tests and/or glycated hemoglobin (HbA1c) levels, we estimated the rate of change in metabolic measures per 6 months and assessed the association between potential risk factors for diabetes and rate of change using multivariate regression models.. Per 6-month time, HbA1c increased by 0.062% with a standard error of 0.029% (P = 0.037) and the ratio (area under the curve (AUC) C-peptide to AUC glucose from mixed meal tolerance testing) decreased by 0.0028 with a standard error of 0.0011 (P = 0.014). We observed more rapid decline in smokers (AUC C-peptide, P = 0.043) and patients with surgical drainage (AUC glucose, P = 0.001; ratio, P = 0.03) or with calcific pancreatitis (HbA1c, P = 0.003). In multivariate models, AUC C-peptide and ratio declined at a greater rate in smokers and HbA1c in those with pancreatic calcifications (both P < 0.05).. We observed a measurable decline in β-cell function and glycemic control in patients with CP. Patients with a history of tobacco smoking, surgical drainage, or pancreatic calcification may be at highest risk.

    Topics: Adolescent; Adult; Blood Glucose; C-Peptide; Diabetes Mellitus; Disease Progression; Female; Glucose Tolerance Test; Glycated Hemoglobin; Humans; Islets of Langerhans; Islets of Langerhans Transplantation; Male; Middle Aged; Pancreatic Diseases; Pancreatitis, Chronic; Risk Factors; Young Adult

2019
Serum Vitamin D and Its Upregulated Protein, Thioredoxin Interacting Protein, Are Associated With Beta-Cell Dysfunction in Adult Patients With Type 1 and Type 2 Diabetes.
    Canadian journal of diabetes, 2018, Volume: 42, Issue:6

    Diabetes mellitus is characterized by either complete deficiency of insulin secretion, as in type 1 diabetes, or decompensation of the pancreatic beta cells in type 2 diabetes. Both vitamin D (vitD) and thioredoxin interacting protein (TXNIP) have been shown to be involved in beta-cell dysfunction. Therefore, this study was designed to examine vitD and TXNIP serum levels in patients with diabetes and to correlate these levels with beta-cell function markers in both types of diabetes.. The routine biochemical parameters and the serum levels of vitD and TXNIP were measured in 20 patients with type 1 diabetes and 20 patients with type 2 diabetes. The levels were then compared to those of 15 healthy control volunteers. Insulin, C-peptide and proinsulin (PI), vitD and TXNIP were measured by ELISA. Beta-cell dysfunction was assessed by homeostatic model assessment (HOMA-beta), proinsulin-to-C-peptide (PI/C) and proinsulin-to-insulin (PI/I) ratios. Correlations among various parameters were studied.. Patients with type 1 diabetes had significantly lower HOMA-beta, vitD and TXNIP levels; however, they had higher PI/C levels than the control group. Meanwhile, patients with type 2 diabetes had significantly higher C-peptide, proinsulin, PI/C, HOMA-insulin resistance (HOMA-IR) and lower HOMA-beta and vitD levels, with no significant difference in TXNIP levels as compared to the control group. In addition, vitD was significantly correlated positively with HOMA-beta and TXNIP and negatively with PI, PI/C, PI/I and HOMA-IR. TXNIP correlated positively with HOMA-beta and negatively with PI/C.. Our data showed that vitD and TXNIP were associated with different beta-cell dysfunction markers, indicating their potential abilities to predict the beta-cell status in people with diabetes.

    Topics: C-Peptide; Carrier Proteins; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Homeostasis; Humans; Insulin; Insulin-Secreting Cells; Male; Middle Aged; Pancreatic Diseases; Proinsulin; Vitamin D

2018
Clinical signature and pathogenetic factors of diabetes associated with pancreas disease (T3cDM): a prospective observational study in surgical patients.
    Acta diabetologica, 2014, Volume: 51, Issue:5

    To characterize the clinical signature and etiopathogenetic factors of diabetes associated with pancreas disease [type 3 diabetes mellitus (T3cDM)]. To estimate incidence and identify predictors of both diabetes onset and remission after pancreatic surgery. A prospective observational study was conducted. From January 2008 to December 2012, patients (n = 651) with new diagnosis of pancreatic disease admitted to the Pancreatic Surgery Unit of the San Raffaele Scientific Institute were evaluated. Hospital and/or outpatient medical records were reviewed. Blood biochemical values including fasting blood glucose, insulin and/or C-peptide, glycosylated hemoglobin and anti-islet antibodies were determined. Diabetes onset was assessed after surgery and during follow-up. At baseline, the prevalence of diabetes was 38 % (age of onset 64 ± 11 years). In most cases, diabetes occurred within 48 months from pancreatic disease diagnosis. Among different pancreatic diseases, minor differences were observed in diabetes characteristics, with the exception of the prevalence. Diabetes appeared associated with classical risk factors for type 2 diabetes (i.e., age, sex, family history of diabetes and body mass index), and both beta-cell dysfunction and insulin resistance appeared relevant determinants. The prevalence of adult-onset autoimmune diabetes was as previously reported within type 2 diabetes. Within a few days after surgery, either diabetes remission or new-onset diabetes was observed. In patients with pancreatic cancer, no difference in diabetes remission was observed after palliative or resective surgery. Classical risk factors for type 2 diabetes were associated with the onset of diabetes after surgery. T3cDM appeared as a heterogeneous entity strongly overlapped with type 2 diabetes.

    Topics: Adult; Aged; Blood Glucose; C-Peptide; Diabetes Mellitus; Female; Glycated Hemoglobin; Humans; Male; Middle Aged; Pancreatic Diseases; Prospective Studies; Young Adult

2014
Defective glucagon secretion during hypoglycemia after intrahepatic but not nonhepatic islet autotransplantation.
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2014, Volume: 14, Issue:8

    Defective glucagon secretion during hypoglycemia after islet transplantation has been reported in animals and humans with type 1 diabetes. To ascertain whether this is true of islets from nondiabetic humans, subjects with autoislet transplantation in the intrahepatic site only (TP/IAT-H) or in intrahepatic plus nonhepatic (TP/IAT-H+NH) sites were studied. Glucagon responses were examined during stepped hypoglycemic clamps. Glucagon and symptom responses during hypoglycemia were virtually absent in subjects who received islets in the hepatic site only (glucagon increment over baseline = 1 ± 6, pg/mL, mean ± SE, n = 9, p = ns; symptom score = 1 ± 1, p = ns). When islets were transplanted in both intrahepatic + nonhepatic sites, glucagon and symptom responses were not significantly different than Control Subjects (TP/IAT-H + NH: glucagon increment = 54 ± 14, n = 5; symptom score = 7 ± 3; control glucagon increment = 67 ± 15, n = 5; symptom score = 8 ± 1). In contrast, glucagon responses to intravenous arginine were present in TP/IAT-H recipients (TP/IAT: glucagon response = 37 ± 8, n = 7). Transplantation of a portion of the islets into a nonhepatic site should be seriously considered in TP/IAT to avoid posttransplant abnormalities in glucagon and symptom responses to hypoglycemia.

    Topics: Adult; Arginine; Autografts; Blood Glucose; C-Peptide; Diabetes Mellitus, Type 1; Female; Glucagon; Humans; Hypoglycemia; Insulin; Islets of Langerhans; Islets of Langerhans Transplantation; Liver; Male; Pancreatectomy; Pancreatic Diseases; Pancreatic Ducts; Pancreatitis; Treatment Outcome

2014
[Postprandial hypoglycemia].
    Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion, 2012, Volume: 59, Issue:5

    Topics: Blood Glucose; C-Peptide; Choristoma; Confusion; Diagnosis, Differential; Fasting; Female; Humans; Hyperinsulinism; Hypoglycemia; Insulin; Insulin Secretion; Insulinoma; Middle Aged; Nesidioblastosis; Pancreatectomy; Pancreatic Diseases; Postprandial Period; Spleen; Syncope

2012
Alleviation of hyperglycemia in diabetic rats by intraportal injection of insulin-producing cells generated from surgically resected human pancreatic tissue.
    The Journal of endocrinology, 2011, Volume: 208, Issue:3

    Although islet transplantation holds promise for the treatment of diabetes, the scarcity of donor tissue remains a major drawback. The aim of this study is to generate insulin-producing cells from adult human pancreatic cells isolated from surgically resected pancreatic tissue. To isolate pancreatic endocrine precursor cells from 57 surgically resected pancreases, the cells were cultured and propagated in conditioned medium after which they were differentiated in Matrigel. The resultant cells were characterized using morphology, immunofluorescent studies, expression of differentiated pancreatic islet-specific genes using quantitative reverse transcription-PCR, and glucose-induced insulin secretion through analysis of C-peptide secretion. The relationships between propagation of insulin-producing cells and clinical variables of the donor were also analyzed. Finally, insulin-producing cell function was examined in streptozotocin-induced diabetic rats. Pancreatic endocrine precursor cells were successfully cultured; insulin-producing cells cultured from soft pancreas parenchyma had a significantly higher success rate. Morphological examination revealed islet-like cluster formation upon transfer to Matrigel. The presence of the neural stem cell marker nestin, duct cell marker cytokeratin 19, and endocrine cell markers C-peptide and pancreatic and duodenal homeobox 1, was also observed. In addition, glucose-stimulated C-peptide release was significantly increased in the insulin-producing cells. Furthermore, in diabetic rats, transplantation of insulin-producing cells reduced hyperglycemia. Isolated pancreatic endocrine precursor cells from surgically resected pancreatic tissue differentiated into insulin-producing cells and showed characteristics of functional endocrine cells. Thus, surgically resected pancreatic tissue may represent an alternative source of functional insulin-producing cells.

    Topics: Adult; Aged; Animals; C-Peptide; Cells, Cultured; Diabetes Mellitus, Experimental; Diabetes Mellitus, Type 1; Homeodomain Proteins; Humans; Hyperglycemia; Insulin; Insulin Secretion; Insulin-Secreting Cells; Intermediate Filament Proteins; Keratin-19; Male; Middle Aged; Nerve Tissue Proteins; Nestin; Pancreas; Pancreatic Diseases; Rats; Tissue Donors; Transplantation, Heterologous; Treatment Outcome

2011
Insulinoma-induced hypoglycemia in a patient with nesidiodysplasia after vagomotomy and pyloroplasty for duodenal ulcer.
    The American journal of the medical sciences, 2009, Volume: 337, Issue:5

    A 45-year-old woman was referred to us for hypoglycemia. The patient had been operated on for a duodenal ulcer by bilateral troncular vagotomy and pyloroplasty 20 years ago and, since then, she showed a dumping syndrome. Two months before consultation she developed repetitive episodes of symptomatic hypoglycemia. An oral glucose tolerance test showed hypoglycemia with endogenous hyperinsulinism. The continuous glucose monitoring system sensor demonstrated fasting hypoglycemia. The endoscopic ultrasound of the pancreas showed a pancreatic tumor that was confirmed in the pathologic study after surgery. Moreover, nesidiodysplasia image was found surrounding pancreatic parenchyma. We report, for the first time, both histologic lesions associated in a patient with a history of vagotomy and pyloroplasty for a duodenal ulcer and we discuss the possible pathogenic mechanisms.

    Topics: C-Peptide; Duodenal Ulcer; Female; Glucose; Glucose Tolerance Test; Humans; Hypoglycemia; Insulin; Insulinoma; Islets of Langerhans; Middle Aged; Pancreatic Diseases; Pancreatic Neoplasms; Time Factors; Vagotomy

2009
Hyperinsulinism in tyrosinaemia type I.
    Journal of inherited metabolic disease, 2005, Volume: 28, Issue:2

    Tyrosinaemia type I (TT I) (McKusick 276700) is a heterogeneous disorder with a broad spectrum of clinical phenotypes. Although histological abnormalities of the pancreas are well recognized, there are only incidental reports of pancreatic dysfunction manifested as insulin-dependent diabetes mellitus. We report three subjects with TT I and acute liver dysfunction who had hyperinsulinism in early infancy. Hypoglycaemia persisted despite dietary treatment and one patient had inadequate lipolysis at the time of hypoglycaemia. All three patients were successfully treated with diazoxide (10 mg/kg per day) and chlorthiazide (35 mg/kg per day) and treatment was gradually withdrawn after 9, 13 and 34 months, respectively. The mechanism of pancreatic dysfunction in TT I is unknown but may be related to the toxic metabolites that accumulate in this condition. We conclude that hyperinsulinism is not a rare complication in TT I. In patients with persistent hypoglycaemia, C-peptide should always be measured. Treatment with diazoxide and chlorthiazide is highly effective, appears to be safe, and does not need to be continued lifelong.

    Topics: Blood Glucose; C-Peptide; Chlorothiazide; Diazoxide; Diuretics; Humans; Hyperinsulinism; Hypoglycemia; Infant, Newborn; Infant, Newborn, Diseases; Insulin; Liver Diseases; Pancreatic Diseases; Sodium Chloride Symporter Inhibitors; Tyrosinemias

2005
Islet cell autoimmunity in youth onset diabetes mellitus in Northern India.
    Diabetes research and clinical practice, 2001, Volume: 53, Issue:1

    We characterised a consecutive cohort of 132 youth onset diabetic individuals (age at onset<30 years, mean duration of disease 5.5+/-6.0 years) from North India, by serological determination of the determination of the islet cell autoantibodies, GAD(65) and IA2, and clinically for coexisting autoimmune thyroid disease, malnutrition and pancreatic calcification. Five types of diabetes were delineated: Type 1 (37%), ketosis resistant (32%), Type 2 (13%), fibrocalculous pancreatopathy (11%) and autoimmune polyglandular syndrome (7%). C-peptide response to glucagon was assessed in a representative subset of 50 patients with Type 1, ketosis resistant, and autoimmune polyglandular syndrome. A total of 22.4% of Type 1 and 30% of autoimmune polyglandular syndrome subjects showed both GAD(65) plus IA-2 autoantibody positivity, significantly more than the 4.7% positivity shown by the ketosis resistant type. However, GAD(65) antibody positivity alone was seen in 38% of ketosis resistant subjects which was significantly more than the 14.2 and 10% positivity seen in Type 1 and autoimmune polyglandular groups, respectively. The fibrocalculous pancreatopathy group showed GAD(65) plus IA-2 autoantibody positivity in 14.2% and GAD(65) autoantibody alone positivity in 7.1%. 26 and 60%, respectively, of the Type 1 and autoimmune polyglandular syndrome groups had thyroid microsomal autoantibody positivity. Type 1 showed significantly less C-peptide response to glucagon when compared to the ketosis resistant and autoimmune polyglandular syndrome groups. The controls and Type 2 diabetic individuals tested negative for islet cell autoimmunity markers. These findings demonstrate a role of islet cell autoimmunity in the pathogenesis of four out of the five clinical types of youth onset diabetes seen in North India.

    Topics: Adolescent; Adult; Age of Onset; Asian People; Autoantibodies; C-Peptide; Cohort Studies; Diabetes Mellitus; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diagnosis, Differential; Female; Glutamate Decarboxylase; Humans; India; Islets of Langerhans; Isoenzymes; Male; Pancreatic Diseases; Thyroid Gland

2001
Correction of pancreatic beta-cell dysfunction with coenzyme Q(10) in a patient with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes syndrome and diabetes mellitus.
    European neurology, 2000, Volume: 43, Issue:1

    Topics: Adult; C-Peptide; Diabetes Complications; Female; Gene Expression; Humans; Islets of Langerhans; MELAS Syndrome; Pancreatic Diseases; Point Mutation; Ubiquinone

2000
Distribution of autoantibodies to glutamic acid decarboxylase across the spectrum of diabetes mellitus seen in South Africa.
    Diabetic medicine : a journal of the British Diabetic Association, 2000, Volume: 17, Issue:7

    This study investigated the association between glutamic acid decarboxylase antibodies (GAD-AB) and Type 1, Type 2, pancreatic and lipoatrophic diabetes mellitus (DM) in South African patients.. Four groups were selected: group A, 100 Black Type 1 DM patients (age at onset < 35 years, body mass index (BMI) < 27 kg/m2 and insulin dependent within 1 year of presentation); group B, 80 Black Type 2 DM patients (age at onset > 35 years, BMI > 27 kg/m2 and controlled on oral hypoglycaemic agents for at least 1 year after presentation); group C, 10 patients of varying ethnicity with DM or impaired glucose tolerance secondary to chronic pancreatitis; group D, five patients of varying ethnicity with DM associated with total lipodystrophy. Fifty healthy Black control subjects were also studied (group E). Serum GAD-AB and random C-peptide levels were measured by radioimmunoassay.. Mean C-peptide concentration was significantly lower in Type 1 DM patients than Type 2 DM patients (P < 0.00001). Forty-four patients with Type 1 DM were GAD-AB-positive compared to two patients with Type 2 DM. Two control subjects were also GAD-AB-positive. No patient in the other groups had a titre > 1 U/ml. Type 1 DM patients who were GAD-AB-positive did not differ from those who were GAD-AB-negative for age at onset, duration of DM or C-peptide concentrations.. Auto-immune beta-cell destruction has an important role in the pathogenesis of Type 1 DM amongst African patients. However, Type 2 African DM patients and other diabetes subtypes are largely GAD-AB-negative.

    Topics: Adult; Autoantibodies; Black People; C-Peptide; Diabetes Mellitus; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Glutamate Decarboxylase; Humans; Male; Middle Aged; Pancreatic Diseases; Radioimmunoassay; South Africa

2000
Antibodies to pancreatic islet cell antigens in diabetes seen in Southern India with particular reference to fibrocalculous pancreatic diabetes.
    Diabetic medicine : a journal of the British Diabetic Association, 1998, Volume: 15, Issue:2

    Fibrocalculous pancreatic diabetes (FCPD) is a type of diabetes secondary to tropical chronic non-alcoholic pancreatitis. Little is known about the aetiopathogenesis of FCPD. We studied glutamic acid decarboxylase antibodies (GAD-Ab) and islet cell antibodies (ICA) in patients with FCPD and compared the results with Type 1 (insulin dependent) diabetes mellitus, Type 2 (non-insulin-dependent) diabetes mellitus and non-diabetic subjects in Southern India. The prevalence of GAD-Ab was 7.0% (95% Confidence Interval (CI) 1.9-17.2) in FCPD, 47.5% (CI 31.4-64.0) in Type 1 (p < 0.001 compared to FCPD), 5.6% (CI 1.5-13.9) in Type 2 (non-significant (NS) compared to FCPD) and 0% in controls. The prevalence of ICA was 6.3% (CI 1.2-17.4) in FCPD, 53.8% (CI 37.1-70.0) in Type 1 (p < 0.001 compared to FCPD), 9.9% (CI 4.0-19.4) in Type 2 (NS compared to FCPD) and 4.7% (CI 0.4-16.1) in controls. The data suggest that in FCPD, the frequency of auto-antibodies is low and its aetiology is probably not linked to autoimmunity in the majority of the patients.

    Topics: Adult; Autoantigens; C-Peptide; Chronic Disease; Diabetes Mellitus; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Glutamate Decarboxylase; Humans; India; Islets of Langerhans; Male; Middle Aged; Pancreatic Diseases; Pancreatitis; Reference Values

1998
Prospective study of nesidioblastosis in newborns and infants: hypoglycemic seizures, epileptogenesis and the significance of the C-peptide suppression test in pancreatectomy.
    Acta paediatrica Japonica : Overseas edition, 1997, Volume: 39, Issue:1

    The long-term follow-up of chronic hyperinsulinemic seizures, epileptogenesis and other neurological complications in five patients who were treated with conservative therapy followed by pancreatectomy during the neonatal period and infancy, who were confirmed to have diffuse nesidioblastosis are described. The reaction pattern of the C-peptide (CPR) suppression test and its relation to the final extent of pancreatectomy was examined in four patients. The chronological change in electro-encephalography (EEG) and its epileptogenesis was also examined in each patient during hyperinsulinemic hypoglycemia, and during normoglycemia in a long-term post-pancreatectomy follow-up. All patients demonstrated several types of hypoglycemic seizures, ranging from apnea, erratic seizures, evolving to generalized/unilateral tonic-clonic or tonic seizures, myoclonic seizures and EEG abnormalities. Four of five patients still suffered from epilepsy at the age of 4-22 years. The reaction pattern of the CPR suppression test showed dichotomy, with a hyper-reactive pattern in two patients who required total pancreatectomy to control hypoglycemia, and a suppression pattern in two other patients treated with 90-95% pancreatectomy. Neonatal onset and subsequent myoclonic seizures were ominous signs of epileptogenesis to various types of intractable epilepsy and other neurological sequelae. A prompt diagnosis and pancreatectomy of a sufficient extent at the first operation are essential. The CPR suppression test may be useful for a prompt diagnosis and selection of the extent of pancreatectomy.

    Topics: Blood Chemical Analysis; C-Peptide; Epilepsy; Female; Humans; Hyperinsulinism; Hypoglycemia; Infant; Infant, Newborn; Male; Pancreatectomy; Pancreatic Diseases; Pancreatic Function Tests; Prospective Studies

1997
Selective intra-arterial calcium injection in the investigation of adult nesidioblastosis: a case report.
    Diabetic medicine : a journal of the British Diabetic Association, 1997, Volume: 14, Issue:11

    A 69-year-old man with recurrent hypoglycaemia had inappropriately elevated plasma insulin level during a symptomatic hypoglycaemia, but had a negative prolonged fast. Computerized tomography (CT) of the abdomen revealed a nodular lesion over the body of pancreas, whereas pancreatic arteriography failed to show tumour blush. Hence, arterial stimulation (with calcium) and venous sampling (ASVS) was performed and a brisk response of plasma insulin level was found when calcium was injected both into the splenic and the superior mesenteric arteries. Since no tumour was found during the operation, the patient received subtotal distal pancreatectomy. Pathological examination of the resected tissue disclosed a typical finding of nesidioblastosis. We suggest that selective intra-arterial calcium injection with hepatic venous sampling for insulin gradients is useful for the diagnosis of adult nesidioblastosis.

    Topics: Aged; Blood Glucose; C-Peptide; Calcium; Humans; Injections, Intra-Arterial; Insulin; Islets of Langerhans; Male; Mesenteric Artery, Superior; Pancreatectomy; Pancreatic Diseases; Splenic Artery

1997
Exocrine pancreatic and beta-cell function in malnutrition-related diabetes among north Indians.
    Diabetes care, 1995, Volume: 18, Issue:8

    To compare the pancreatic exocrine and beta-cell function in the two variants of malnutrition-related diabetes mellitus (MRDM): fibrocalculous pancreatic diabetes (FCPD) and protein-deficient pancreatic diabetes (PDPD).. Fecal chymotrypsin (FCT) and fasting C-peptide levels were measured in 20 consecutive patients with FCPD and 19 with PDPD. FCPD was diagnosed by pancreatic calcification on ultrasonography, while the diagnosis of PDPD was made on the basis of low body mass index, severe diabetes requiring insulin therapy, and ketosis resistance on interruption of insulin. Twenty patients with type I diabetes and 32 healthy subjects served as control subjects.. Both FCPD and PDPD patients had diminished levels of FCT when compared with those of control subjects and patients with type I diabetes. However, FCT levels were significantly lower in subjects with FCPD (median 0.4 U/g, range 0-8.9 U/g), in comparison with those with PDPD (4.7 U/g, 0.6-40.5 U/g; P < 0.001). Of the FCPD patients, 13 of 20 (65%) had severe exocrine pancreatic deficiency (FCT < 1 U/g) vs. 3 of 19 (15.8%) PDPD subjects (P < 0.01). In comparison with control subjects, fasting serum C-peptide levels were significantly diminished in both MRDM groups. However, C-peptide levels in subjects with FCPD (mean +/- SE, 0.22 +/- 0.04 nmol/l) and PDPD (0.26 +/- 0.04 nmol/l) were comparable.. Among the two variants of MRDM, subjects with FCPD have severe pancreatic exocrine deficiency in comparison with those with PDPD, even though their C-peptide levels are comparably diminished. This suggests that the pathogenesis of these two entities may differ or that the genetic and/or environmental factors leading to exocrine damage are different.

    Topics: Adult; Blood Glucose; Body Mass Index; C-Peptide; Chymotrypsin; Diabetes Mellitus; Diabetes Mellitus, Type 1; Feces; Female; Glycated Hemoglobin; Humans; India; Insulin; Insulin Secretion; Islets of Langerhans; Male; Nutrition Disorders; Pancreas; Pancreatic Diseases; Reference Values; Statistics, Nonparametric

1995
Hyperinsulinemic hypoglycemia of infancy (nesidioblastosis) in clinical remission: high incidence of diabetes mellitus and persistent beta-cell dysfunction at long-term follow-up.
    The Journal of clinical endocrinology and metabolism, 1995, Volume: 80, Issue:2

    In persistent hyperinsulinemic hypoglycemia of infancy (PHHI), the long term outcome of the disease is not well documented. Previous reports suggested that partial pancreatectomy in infants does not endanger future islet function. We evaluated endocrine pancreatic function in 14 PHHI patients 6.5-21 yr after diagnosis. Eight underwent early subtotal pancreatectomy, and 6 were medically treated; all were in clinical remission. Intravenous glucose tolerance and C-peptide suppression tests were performed, with multiple determinations of hormone levels. The insulin response to glucose was blunted in all pancreatectomized and in 2 conservatively treated patients. Glucose disposal was reduced in 6 pancreatectomized patients and in 2 medically treated subjects. Six of the pancreatectomized patients, including two with normal glucose disposal at first evaluation, developed overt diabetes during puberty. None in the medically treated group became diabetic; however, only 2 patients have reached puberty. C-Peptide suppression in response to hypoglycemia was inadequate in 4 of 5 pancreatectomized and 3 of 5 nonpancreatectomized patients studied. These results show that children with PHHI have impaired insulin responses to glucose and lack of suppressibility of endogenous insulin secretion several years after clinical remission. Thus, the beta-cell defect responsible for the disease in infancy is not corrected with time despite the disappearance of spontaneous hypoglycemia. Insulin secretion seems more disturbed in pancreatectomized patients; the majority develop insulin-requiring diabetes during puberty. An effort should be made to treat PHHI patients medically to avoid pancreatectomy; this may reduce the incidence of diabetes at puberty.

    Topics: Adolescent; C-Peptide; Child; Diabetes Mellitus; Diazoxide; Female; Follow-Up Studies; Glucose Tolerance Test; Humans; Islets of Langerhans; Male; Octreotide; Pancreatectomy; Pancreatic Diseases; Prospective Studies; Time Factors

1995
A case of familial nesidioblastosis: prenatal diagnosis of foetal hyperinsulinism.
    Acta paediatrica (Oslo, Norway : 1992), 1992, Volume: 81, Issue:10

    Persistent neonatal hyperinsulinaemic hypoglycaemia due to nesidioblastosis is a rare condition probably transmitted by an autosomal recessive inheritance. Recurrent hypoglycaemic episodes become evident after birth and cause severe neurological damage without intensive treatment. The intrauterine detection of hypoglycaemia and hyperinsulinism in newborns subsequently diagnosed as affected by nesidioblastosis has not yet been reported. We describe a case of familial nesidioblastosis in which an intrauterine diagnosis could be suggested by high levels of insulin and C-peptide and low values of glucose in the amniotic fluid.

    Topics: Amniocentesis; Blood Glucose; C-Peptide; Humans; Hyperinsulinism; Infant, Newborn; Insulin; Male; Pancreatic Diseases; Pedigree; Prenatal Diagnosis

1992
Renal hemodynamics and albumin excretion rate in patients with diabetes secondary to acquired pancreatic disease.
    Diabetes care, 1992, Volume: 15, Issue:11

    OBJECTIVE--To assess kidney function and AER in patients with PD. RESEARCH DESIGN AND METHODS--Thirty-three patients with PD (age 52 +/- 7 yr, duration of disease 11 +/- 6 yr, BMI 24 +/- 3 kg/m2) and 33 patients with IDDM were matched for sex, BMI, and duration of disease. GFR and RPF were determined by single injection of [51Cr]EDTA and [125I]hippurate. AER was measured by radioimmunoassay in a single timed overnight urine collection. RESULTS--GFR and RPF were, respectively, 113 +/- 35 and 441 +/- 145 ml.min-1.73 m2 in patients with PD and 123 +/- 30 and 549 +/- 94 (P < 0.001) in IDDM. FF was significantly higher in patients with PD (0.26 +/- 0.05 vs. 0.22 +/- 0.03; P < 0.001). Prevalence of hyperfiltration (GFR > 135 ml.min-1.1.73 m2) was similar in both groups (30% in patients with PD vs. 28% in those with IDDM). Geometric mean of urinary AER was 10.4 micrograms/min (range 1-186) in patients with PD and 11.2 (1-198) in IDDM patients. Some 30.3% of patients with PD and 18% of those with IDDM were microalbuminuric (AER > 20 micrograms/min). By multiple regression analysis, AER was significantly related to systolic (P < 0.04) and diastolic blood pressure (P < 0.01) and to BMI (P < 0.03) in patients with PD. Retinopathy was more frequent in microalbuminuric patients with PD than in those without elevated AER. CONCLUSIONS--We suggest that early renal abnormalities occur similarly in patients with PD and IDDM.

    Topics: Adult; Albuminuria; Body Mass Index; C-Peptide; Diabetes Mellitus; Diabetes Mellitus, Type 1; Glomerular Filtration Rate; Humans; Kidney; Middle Aged; Pancreatic Diseases; Regional Blood Flow; Renal Circulation

1992
The density, contour, and thickness of the pancreas in diabetics: CT findings in 57 patients.
    AJR. American journal of roentgenology, 1992, Volume: 159, Issue:3

    Insulin has a trophic effect on pancreatic acinar tissue, so the pancreas might be expected to atrophy in persons who have diabetes. Accordingly, we analyzed the density, contour (smooth or lobulated), and thickness of the pancreas on CT scans of diabetic patients and compared the results with those in control subjects. The prevalence of pancreatic lobulation (incisurae deeper than 2 mm) and its correlation with age in diabetic and control subjects were determined. The thickness of the pancreas was measured at three levels (head, body, tail). Three groups of diabetic patients were examined: 20 insulin-dependent patients, 25 patients not treated with nor dependent on insulin, and 12 patients treated with but not dependent on insulin. A control group included 57 nondiabetic patients. The ages of the control subjects were similar to those of the diabetic patients. The statistical significance of the differences between groups of diabetic patients and control subjects was estimated by using Student's t test for the values of density and thickness and the chi 2-test for the prevalence of pancreatic lobulation. The density of the pancreas in diabetic patients and control subjects was not statistically different. Diabetic patients had increased lobulation of the pancreas. All parts of the pancreas tended to be smaller in diabetic patients, but the degree of reduction varied. It was modest in the patients not treated with insulin, pronounced in insulin-dependent patients, and intermediate in non-insulin-dependent, insulin-treated patients. Moreover, the size of the body was significantly reduced in all three groups, whereas the size of the pancreatic head was preserved in patients not treated with insulin. In conclusion, CT of the pancreas shows that although density in diabetic patients is normal, lobulation is increased. Reduction in size involves the body of the pancreas more than other parts of the gland and is more pronounced in insulin-treated diabetic patients. CT of the pancreas might be useful to predict which diabetic patients will require insulin therapy.

    Topics: Adult; Aged; Aged, 80 and over; Aging; Atrophy; C-Peptide; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Humans; Male; Middle Aged; Pancreas; Pancreatic Diseases; Reference Values; Tomography, X-Ray Computed

1992
Pancreatic C-peptide response to oral glucose in fibrocalculous pancreatic diabetes. Improvement after treatment.
    Diabetes care, 1990, Volume: 13, Issue:5

    beta-Cell function (plasma C-peptide) in 17 fibrocalculous pancreatic diabetic (FCPD) subjects (14 newly diagnosed) was not different at presentation from that in 14 matched insulin-dependent diabetic subjects. After insulin treatment and improvement in the patients' nutritional and metabolic status, fasting and postglucose plasma C-peptide concentrations showed a significant increase (fasting 0.06 +/- 0.01 to 0.17 +/- 0.03 nM, peak 0.11 +/- 0.02 to 0.29 +/- 0.06 nM, mean +/- SE; P less than 0.01 for both). Thus, severely diminished beta-cell function in FCPD is partially reversible after treatment. This could contribute to the clinical metabolic peculiarities of this group of patients.

    Topics: Adult; C-Peptide; Diabetes Mellitus; Diabetes Mellitus, Type 1; Female; Fibrosis; Follow-Up Studies; Fructose; Glucose Tolerance Test; Glycated Hemoglobin; Humans; Insulin; Male; Pancreatic Diseases

1990
Serum immunoreactive trypsin in tropical pancreatic diabetes syndrome.
    Annals of clinical biochemistry, 1989, Volume: 26 ( Pt 1)

    Fifteen patients with tropical pancreatic diabetes syndrome (TPDS), 16 insulin-dependent diabetics (IDD), 27 non-insulin-dependent diabetics (NIDD) and 14 normal subjects, all from India, were investigated for markers of beta-cell (C-peptide) and exocrine (immunoreactive trypsin; IRT) reserve. IRT and C-peptide concentrations were the lowest in TPDS, lower than normal in IDD, and not significantly different from normal in NIDDs. There was a highly significant correlation (rs = 0.93; P less than 0.0001) between IRT and C-peptide (measured in 50% of patients and controls) concentrations when all diabetic groups were combined. Such a correlation was absent when TPDS patients were considered in isolation, largely because of the markedly low IRT concentration. Fourteen of 15 patients (93%) with TPDS had subnormal IRT concentrations, of which 11 had IRT values of less than 50 micrograms/L. These IRT values are similar to those previously reported in cystic fibrosis. Only 6 of 16 IDDs (38%) had subnormal IRT concentrations, of which only one was below 50 micrograms/L. These data suggest that exocrine pancreatic reserve is markedly diminished in TPDS and that a subnormal IRT concentration may be a useful biochemical marker for this form of diabetes.

    Topics: Adolescent; Adult; Biomarkers; C-Peptide; Calculi; Child; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Humans; India; Male; Middle Aged; Pancreatic Diseases; Tropical Climate; Trypsin

1989
Pancreatic exocrine and endocrine function after subtotal pancreatectomy for nesidioblastosis.
    Journal of pediatric surgery, 1988, Volume: 23, Issue:2

    Pancreatic exocrine and endocrine function was assessed in seven patients 1 to 2 years after 95% pancreatectomy (group A) and three patients 9 to 11 years after 75% pancreatectomy (group B). In all cases surgery was undertaken for the treatment of hyperinsulinism and the histologic diagnosis was nesidioblastosis. The activities of pancreatic enzymes and bicarbonate concentrations were generally normal in group B, but were reduced in approximately half the children in group A. One child in group A had significant exocrine failure and poor weight gain. Blood glucose levels and fasting insulin levels were normal during a standard glucose tolerance test in all of the group B patients. One had a low fasting blood glucose level. In the group A patients three had low fasting glucose levels and one a frankly diabetic glucose tolerance test. C peptide and insulin levels were comparable but inappropriate insulin levels were noted in one patient, suggesting that the control of glucose-stimulated insulin release may remain abnormal. The results suggest that pancreatic function is not seriously impaired in the majority of patients 1 to 2 years after 95% pancreatectomy and that it is comparable to that noted in 75% pancreatectomy patients followed over a longer period of time.

    Topics: Amylases; Bicarbonates; Blood Glucose; C-Peptide; Child, Preschool; Humans; Infant; Insulin; Islets of Langerhans; Male; Pancreas; Pancreatectomy; Pancreatic Diseases; Postoperative Period; Trypsin

1988
Exocrine and endocrine pancreatic function in malnutrition-related diabetes mellitus (MRDM) in Yogyakarta, Indonesia.
    The Kobe journal of medical sciences, 1988, Volume: 34, Issue:5

    Topics: Adolescent; Adult; Aged; Amylases; C-Peptide; Calcinosis; Developing Countries; Diabetes Mellitus; Diabetes Mellitus, Type 2; Fasting; Female; Humans; Japan; Male; Manihot; Middle Aged; Pancreas; Pancreatic Diseases; Protein Deficiency

1988
Production of pro-insulin, C-peptide, and insulin in nesidioblastosis, focal islet-cell adenomatosis, and genuine insulomas. A correlated radioimmunochemical, immunohistochemical, and ultrastructural investigation with particular regard to the occurrence
    Diabetes research (Edinburgh, Scotland), 1988, Volume: 8, Issue:4

    Subtotal pancreatectomy specimens from one case of nesidioblastosis, one case of focal adenomatosis, and two cases of insulin-producing islet-cell tumours were studied with special reference to their production of pro-insulin, C-peptide and insulin, and their contents of argyrophil parenchymal cells. Specific immunostaining revealed the presence of abundant cells reacting with pro-insulin, C-peptide, and insulin antiserum; at least the great majority of them were obviously non-argyrophil cells. The content of extractable immunoreactive insulin (IRI) was higher in the cases of nesidioblastosis and focal adenomatosis than in the two insulomas. Molar ratios of IRI to C-peptide immunoreactivity (CPR) varied between 7 and 100. Gel filtration analysis of the extracts revealed two peaks of CPR, corresponding to 3,000 and 10,000 daltons, respectively. Ultrastructurally, the insulin cells in cases of nesidioblastosis and focal adenomatosis contained numerous typical beta granules. In the islet-cell neoplasms some "polycrine" islet cells were also found, containing typical as well as atypical granules with electron dense or pale cores. Some cells even showed a mixture of apparent beta and alpha granules. Despite structural differences and variable contents of IRI and CPR, the predominance of cells reactive with antibodies to pro-insulin, C-peptide, and insulin, and the absence of argyrophil pro-insulin cells in adenomatosis and insulomas indicates that the hormonal products of these parenchymal cells are not any chemically modified insulin or any other member of the insulin family.

    Topics: Adenoma; Adenoma, Islet Cell; Adolescent; Adult; Antibodies, Monoclonal; C-Peptide; Child; Child, Preschool; Female; Humans; Immunoenzyme Techniques; Infant; Insulin; Insulinoma; Islets of Langerhans; Male; Microscopy, Electron; Pancreatic Diseases; Pancreatic Neoplasms; Proinsulin; Radioimmunoassay

1988
A prospective study of glucose profiles, insulin antibody levels and beta cells secretory patterns in non-obese Ugandan diabetic subjects.
    East African medical journal, 1988, Volume: 65, Issue:1

    Topics: Adolescent; Adult; Blood Glucose; C-Peptide; Calcinosis; Chronic Disease; Diabetes Mellitus; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Humans; Insulin; Insulin Antibodies; Insulin Secretion; Islets of Langerhans; Male; Middle Aged; Pancreatic Diseases; Prospective Studies; Uganda

1988
[Hepatopancreatic syndrome in chronic alcoholism].
    Terapevticheskii arkhiv, 1987, Volume: 59, Issue:12

    The results of puncture biopsy of the liver, ultrasonic and angiographic investigation of the liver and pancreas in 114 patients with chronic alcoholism revealed an increment of changes in these organs in parallel with an increase in the duration of chronic alcoholic intoxication. A simultaneous study of immunoreactive insulin (IRI) and C-peptide showed that an increase in the IRI basal level in the patients suffering from alcoholism up to 10 yrs was determined mainly by an increase in the activity of beta-cells. In a long period of alcoholism an increase in the IRI basal level resulted from a decrease in the rate of insulin degradation in the liver as assessed by a lower level of C-peptide. In liver cirrhosis a noticeable decrease in pancreatic incretory function was combined with noticeable disturbance of insulin degradation in the liver. The above investigations showed that there were morphological, functional and clinical signs of the "hepatopancreatic syndrome" in chronic alcoholism.

    Topics: Adult; Alcoholism; C-Peptide; Glucose Tolerance Test; Humans; Insulin; Liver Diseases, Alcoholic; Male; Middle Aged; Pancreatic Diseases; Syndrome; Time Factors

1987
C-peptide secretion in calcific tropical pancreatic diabetes.
    Metabolism: clinical and experimental, 1986, Volume: 35, Issue:9

    Serum C-peptide levels were measured during a glucagon stimulation test in ten normal nonobese controls and 54 diabetic patients with recent onset of diabetes under 30 years of age. Diabetic patients were comprised of 13 CTPD, 23 IDDM, and 18 NIDDM. As similar to IDDM patients, serum C-peptide concentrations did not rise significantly (P greater than 0.05) in response to glucagon administration in CTPD-patients. Mean baseline and peak serum C-peptide concentrations in CTPD-patients were significantly lower (P less than 0.001) than the values in normal controls and NIDDM patients, but were significantly higher (P less than 0.05) than those in IDDM patients. We conclude that CTPD patients have partial C-peptide reserve, which may protect against ketosis and contribute to ketosis resistance in CTPD. Our results also suggest that CTPD patients require insulin treatment. Neither baseline nor peak C-peptide levels after glucagon could discriminate CTPD from IDDM and CTPD from NIDDM.

    Topics: Adult; C-Peptide; Calcinosis; Diabetes Mellitus; Female; Glucagon; Humans; Islets of Langerhans; Male; Pancreatic Diseases; Tropical Climate

1986
Tropical pancreatic diabetes in South India: heterogeneity in clinical and biochemical profile.
    Diabetologia, 1985, Volume: 28, Issue:4

    Clinical and biochemical studies were carried out in 33 patients with diabetes secondary to chronic calcific, non-alcoholic pancreatitis (tropical pancreatic diabetes) and in 35 Type 2 (non-insulin-dependent) diabetic patients and 35 non-diabetic subjects. Despite lower body mass indices, only 25% of patients with tropical pancreatic diabetes had clinical evidence of malnutrition. There was no history of cassava ingestion. Mean serum cholesterol concentration was significantly lower in the tropical pancreatic diabetic patients (p less than 0.01) in comparison with the Type 2 diabetic patients or non-diabetic subjects, due to a significantly decreased concentration of LDL cholesterol (p less than 0.01) and VLDL cholesterol (p less than 0.05). Basal and post-glucose stimulated concentrations of serum C-peptide were highest in those pancreatic diabetic patients (n = 11) who responded to oral hypoglycaemic drugs, intermediate in the majority (n = 17), who were insulin dependent and ketosis resistant and negligible in a small sub-group (n = 5) who were ketosis prone. The occurrence of microangiopathy in pancreatic diabetic patients was common and similar to that in Type 2 diabetic patients. Thus, tropical pancreatic diabetes in South India appears to be heterogeneous with respect to level of nutrition, severity of glucose intolerance, B-cell function, response to therapy and the occurrence of microvascular complications.

    Topics: C-Peptide; Cholesterol; Diabetes Complications; Diabetes Mellitus; Female; Humans; India; Male; Nutrition Disorders; Pancreatic Diseases; Socioeconomic Factors

1985
Plasma proinsulin and C-peptide concentrations in children with hyperinsulinaemic hypoglycaemia.
    Acta paediatrica Scandinavica, 1984, Volume: 73, Issue:3

    Plasma concentrations of proinsulin and C-peptide were measured in five children presenting with severe hypoglycaemia associated with elevated plasma levels of immunoreactive insulin (IRI) in order to determine whether the profile of circulating B-cell products related to the underlying pathophysiology of the pancreas. Results were compared with data from 13 normal infants. Four children, three neonates and a nine year old girl, were subjected to partial or total pancreatectomy. The neonates had nesidioblastosis, nesidioblastosis with a microadenoma, and a functional abnormality without histological derangement respectively; the older child had a localised adenoma. The remaining child, a neonate, had transient hypoglycaemia and elevated IRI levels associated with hyperlactataemia and hyperalaninaemia. All the children had markedly elevated plasma proinsulin concentrations; the highest levels were seen in the child with an isolated adenoma and in the neonate with nesidioblastosis and a microadenoma. Both of these children also had substantially elevated plasma C-peptide concentrations. The remaining three neonates had plasma C-peptide levels, which although in the normal range for normoglycaemia were inappropriately elevated during hypoglycaemia. It is concluded that elevated proinsulin and C-peptide concentrations are seen in children with hypoglycaemia associated with increased plasma IRI levels and that the profile of the concentrations does not provide a reliable marker for the nature of the underlying pancreatic abnormality.

    Topics: Alanine; C-Peptide; Child; Female; Humans; Hypoglycemia; Infant, Newborn; Insulin; Insulinoma; Lactates; Male; Pancreatectomy; Pancreatic Diseases; Pancreatic Neoplasms; Proinsulin

1984
[A 10-year experience with combined diagnosis of pancreatic diseases].
    Meditsinskaia radiologiia, 1984, Volume: 29, Issue:10

    Optimum multimodality examination of the pancreas includes sonographic, radioimmunological, scintigraphic and angiographic studies. Sonography is a method of choice to study anatomotopographic features of the pancreas. The radioimmunoassay is intended both for the mass screening of patients with hepatogastro-duodenal diseases and for the differential diagnosis of chronic pancreatitis by the nature and type of disease. The use of pancreatoscintigraphy should be restricted in view of considerable exposure of patients. Angiography and angioscanning should be performed strictly according to indications with suspicion for a pancreatic tumor.

    Topics: Antigens, Neoplasm; C-Peptide; Chronic Disease; Diagnosis, Differential; Humans; Insulin; Pancreas; Pancreatic Diseases; Pancreatic Function Tests; Pancreatic Neoplasms; Pancreatitis; Radiography; Radioimmunoassay; Radionuclide Imaging; Trypsin; Ultrasonography

1984
[Simultaneous evaluation of exocrine and B cell function of the pancreas after secretin stimulation].
    Acta medica portuguesa, 1983, Volume: 4, Issue:6

    Topics: C-Peptide; Glucose Tolerance Test; Humans; Insulin; Pancreatic Diseases; Pancreatic Function Tests; Prediabetic State; Secretin

1983
Allotransplantation of neonatal pancreas-microfragments in man.
    Hormone and metabolic research. Supplement series, 1983, Issue:13

    We report of an allotransplantation of neonatal pancreatic tissue. The donor was a three-week-old girl with nesidioblastosis, in which a subtotal pancreas resection had to be performed. The pancreas microfragments were injected transcapsularly into the spleen of a patient with juvenile diabetes. During the postoperative course only a short-termed improvement of the diabetic condition was seen.

    Topics: Antilymphocyte Serum; C-Peptide; Diabetes Mellitus, Type 1; Female; Humans; Infant, Newborn; Insulin; Islets of Langerhans Transplantation; Male; Middle Aged; Pancreatic Diseases

1983