Persistence of proinsulin‐only secretion in people with long‐duration diabetes and minimal residual insulin secretion
Authors' conclusion
The presence of stimulated proinsulin secretion in long-standing diabetes with minimal residual C-peptide secretion suggests the persistence of dysfunctional yet meal-responsive beta cells.
Study context
- Population
- People with long-duration diabetes and minimal residual C-peptide secretion (peak <0.3 nmol/L during 2-h mixed-meal tolerance test (MMTT)); T1D n = 44, T2D n = 1, other forms n = 10; all insulin-treatedof cohort of 320
- Participants
- 55 people
- Outcome
- Meal-stimulated proinsulin secretion (peak values and peak-to-basal ratios)
- Follow-up
- Baseline, 60 and 120 min of MMTT
Main finding
As reported in the abstract
Peak C-peptide, median [IQR] (nmol/L)
0.03
0.001–0.12
Peak proinsulin, median [IQR] (pmol/L)
0.8
0.5–1.75
Stimulated proinsulin secretion among participants with non-stimulated C-peptide (n = 14)
5
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Diabetes duration, median [IQR] (years)
- 18 [8-25]
- HbA1c
- 61 mmol/mol (7.7%)
- Insulin dose, median [IQR] (U/kg/day)
- 0.6 [0.47-0.79]
Original publication
Persistence of proinsulin‐only secretion in people with long‐duration diabetes and minimal residual insulin secretion. Diabet Med. Published 22 May 2026. doi:10.
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