The influence of human C-peptide on renal function and glucose utilization in type 1 (insulin-dependent) diabetic patients.

The possible influence of C-peptide administration on renal function and whole body glucose utilization was examined in 11 patients (Group 1) with Type 1 (insulin-dependent) diabetes mellitus. They were given an i.v. insulin infusion during the night before the study and were euglycaemic at the time of examination. The glomerular filtration rate and effective renal plasma flow were measured by clearance techniques using constant-rate infusions of inulin and sodium para-aminohippurate. After baseline measurements C-peptide was infused during two periods of 60 min at rates of 5 and 30 pmol.kg-1.min-1. In a control study 0.9% NaCl was infused during two 60 min periods in ten Type 1 diabetic patients (Group 2). Glomerular filtration rate decreased by 7% (p less than 0.001), effective renal plasma flow increased by 3%, (p less than 0.05) and whole-body glucose utilization rose by approximately 25% (p less than 0.05) above basal during low-dose C-peptide infusion. Group 2 showed an unaltered glomerular filtration rate, effective renal plasma flow and glucose utilization during 60 min of NaCl infusion. The differences between Group 1 and Group 2 in glomerular filtration rate and glucose utilization were statistically significant. It is concluded that short-term administration of C-peptide in physiological amounts to patients with Type 1 diabetes may reduce the glomerular filtration rate and increase whole-body glucose utilization. The results suggest the possibility that short-term C-peptide administration may exert a regulatory influence on renal function and stimulate glucose utilization in Type 1 diabetic patients.