ABSTRACT
Type 1 diabetes is associated with such complications as blindness, kidney failure, and nerve damage. Replacing C-peptide, a hormone normally co-secreted with insulin, has been shown to reduce diabetes-related complications. Interestingly, after nearly 30 years of positive research results, C-peptide is still not being co-administered with insulin to diabetic patients. The following review discusses the potential of C-peptide as an auxilliary replacement therapy and why it's not currently being used as a therapeutic.
Subject(s)
C-Peptide/therapeutic use , Diabetes Complications/therapy , Diabetes Mellitus, Type 1/therapy , Insulin/therapeutic use , Animals , Bibliometrics , C-Peptide/deficiency , C-Peptide/history , C-Peptide/pharmacokinetics , Clinical Trials as Topic , Diabetes Complications/history , Diabetes Complications/metabolism , Diabetes Complications/pathology , Diabetes Mellitus, Type 1/history , Diabetes Mellitus, Type 1/metabolism , Diabetes Mellitus, Type 1/pathology , Disease Models, Animal , History, 20th Century , History, 21st Century , Humans , Insulin/deficiency , Insulin/history , Insulin-Secreting Cells/metabolism , Insulin-Secreting Cells/pathology , Iron/metabolism , Protein Binding , Serum Albumin/metabolism , Serum Albumin/pharmacokinetics , Zinc/metabolismABSTRACT
Starting with the epoch-making discovery of proinsulin, C-peptide has played an important interdisciplinary role, both as part of the single-chain precursor molecule and as an individual entity. In the pioneering years, fundamental systematic experiments unravelled new biochemical mechanisms and chemical structures. After the first detection of C-peptide in human serum, it quickly became a most useful independent indicator of insulin biosynthesis and secretion, finding application in a rapidly growing number of clinical investigations. A prerequisite was the development of specific immuno assays for proinsulin and C-peptide. Further milestones were: the chemical synthesis of several C-peptides and the accomplishments in the synthesis of proinsulin; the detection of preproinsulin with its bearings on understanding protein biosynthesis; the pioneering role of insulin, proinsulin, C-peptide, and mini-C-peptides in the development of recombinant DNA technology; and the discovery of the enzymes for the endoproteolytic processing of proinsulin into insulin and C-peptide, completing the pathway of biosynthesis. Today, C-peptide continues to serve as a special diagnostic tool in Diabetology and related fields. Thus, its passive role is well established. Evidence for its active role in physiology and pathophysiology is more recent and is subject of the following contributions.
