Diabetic Ketoacidosis: Evidence for C-Peptide and Proinsulin Secretion following Recovery

Abstract

During episodes of ketoacidosis, seven diabetics had very low or unmeasurable circulating insulin, proinsulin and C-peptide levels. Two to 20 weeks later, while still receiving insulin therapy, all patients had evidence of beta cell secretory activity as assessed by C-peptide immunoreactivity (CPR). Subsequently, three patients have been managed on diet alone, while the dose of insulin has been substantially reduced in two. Thus, the occurrence of ketoacidosis does not necessarily indicate irreversible beta cell failure. The possible reasons for temporary cessation and recovery of beta cell secretory function in these cases are discussed.