1987 Volume 34 Issue 4 Pages 561-567
Serum C-peptide responses to glucagon and daily urine C-peptide excretion in successive periods of different treatment in two groups of patients with non-insulin-dependent diabetes mellitus (NIDDM)(mean interval between two tests<1 month) were compared. In group A patients (n=8), the glycemic control was improved after transferring the treatment from sulfonylurea (SU) to insulin (fasting plasma glucose: SU: 192±47, insulin: 127±21mg/dl, mean±S.D., p<0.01). Fasting serum C-peptide immunoreactivity (CPR) was significantly lower at the period of insulin treatment (SU: 1.93±1.01, insulin: 1.47±0.79ng/ml, p<0.05), but there was no difference in the increase in serum CPR (maximal-fasting)(Δ serum CPR) during glucagon stimulation in the two periods of treatment (SU: 1.70±0.72, insulin: 1.47±0.98ng/ml). In group B patients (n=7), there was no significant difference in glycemic control after transferring the treatment from insulin to SU (fasting plasma glucose: insulin: 127±24, SU: 103±13mg/dl). Fasting serum CPR was significantly lower during the period of insulin treatment (insulin: 1.39±0.64, SU: 2.21±0.86ng/ml, p<0.025), but Δ serum CPR during glucagon stimulation still showed no significant difference between the two periods (insulin: 1.97±1.16, SU: 2.33±1.57 ng/ml). On the other hand, daily urine CPR excretion was constantly lower during insulin treatment than during SU treatment in both groups (group A: SU: 65.6±23.2, insulin: 37.1±15.3μg p<0.01, group B: insulin: 40.3±14.7, SU: 65.6±12.4μg, p<0.01). The data suggest that basal and daily pancreatic B-cell secretion in NIDDM patients varies within the short periods of different treatment. However, the CPR response to glucagon remains stable.
