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RESEARCH PRODUCT

The physiological impact of proinsulin C-peptide

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Abstract The proinsulin C-peptide fulfills an important function in the biosynthesis of insulin by facilitating the formation of the correct secondary and tertiary structure of the hormone. C-peptide and insulin are released in equimolar amounts to the circulation but C-peptide has generally been considered to be biologically inert. However, recent studies indicate that C-peptide administration to type 1 diabetes patients is accompanied by improved renal function, amelioration of autonomic dysfunction, stimulated tissue glucose utilization and augmented skin and muscle blood flow. The cellular mechanisms underlying these effects may be related to C-peptide's capacity to stimulate both Na + , K + -ATPase and endothelial nitric oxide synthase (eNOS). The possibility that C-peptide may be beneficial in the long term treatment of patients with type 1 diabetes should be considered.