The effect of human proinsulin C-peptide on erythrocyte deformability in patients with Type I diabetes mellitus

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Abstract

Aims/hypothesis. In recent years, evidence has arisen that proinsulin C- peptide exerts biological effects especially on microcirculation, e.g. C- peptide has been shown to increase skin microcirculation in patients with Type I (insulin-dependent) diabetes mellitus and to activate endothelial nitric oxide synthase. This study aimed to investigate the influence of proinsulin C-peptide on erythrocyte deformability which was assessed by means of laser diffractoscopy. Methods. Blood samples from healthy control subjects (n = 10) and Type I diabetic patients (n = 15) completely deficient of C- peptide were analysed at shear stresses ranging from 0.3 to 30 Pa. Results. Erythrocyte deformability was lower in the group of Type I diabetic patients than in the control subjects. Preincubation of the diabetic blood samples with various concentrations of human proinsulin C-peptide for 8 h restored the deformability of erythrocytes, almost reaching the values of control samples. In contrast, proinsulin C-peptide did not modify the erythrocyte deformability of control subjects. Conclusion/interpretation. We conclude that proinsulin C-peptide is able to ameliorate the impaired deformability of erythrocytes in Type I diabetic patients and we hypothesise that this effect is mediated by restoration of Na+-K+-ATPase activity, which is known to be attenuated in diabetic patients.

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Kunt, T., Schneider, S., Pfützner, A., Goitum, K., Engelbach, M., Schauf, B., … Forst, T. (1999). The effect of human proinsulin C-peptide on erythrocyte deformability in patients with Type I diabetes mellitus. Diabetologia, 42(4), 465–471. https://doi.org/10.1007/s001250051180

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