Zeno L. Charles-Marcel, MD
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Charles-Marcel Z.; Intensive Therapy Preserves Insulin Secretion. Ann Intern Med. 1998;129:914. doi: 10.7326/0003-4819-129-11_Part_1-199812010-00020
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Published: Ann Intern Med. 1998;129(11_Part_1):914.
TO THE EDITOR:
The most recent article by the DCCT Research Group  was intriguing and thought-provoking. I wish to hypothesize another potential benefit of sustaining islet-cell function apart from maintenance of C-peptide secretion. The hypothesis may also partially explain the better metabolic control and lower risk for hypoglycemia seen in the C-peptide responders.
Amylin (islet amyloid polypeptide) is normally co-secreted with insulin by pancreatic β cells . It is reasonable to assume that preservation of β-cell function in patients with type 1 diabetes should not only permit a residual insulin (C-peptide) response but also maintain detectable plasma amylin levels, albeit low levels. Preserved amylin secretion would be expected to contribute to improved glycemic control by reducing postprandial hyperglycemic excursions through retarding gastric emptying and inhibiting amino acid-stimulated glucagon secretion .
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