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Question: From Huntsville, Texas, USA: Reports from Sweden and US (rat studies) seem to indicate that C-peptide and insulin reduce vascular and neural dysfunction in diabetics. Is this combination being used anywhere regularly or in clinical studies anywhere, and if so, where? I am parent of 32 year old Type 1 diabetic who has had it for 24 years. Answer: Not long ago there was an article by Thomas Maugh 11, a science writer with the L.A. Times, reporting some studies from Washington University in St. Louis, Missouri, which had showed that in chemically induced diabetic rats microvascular and neurological complications could be both prevented and alleviated by supplementing insulin with C-peptide, the other fraction of pro-insulin (Ido.Y. et al., Science, Vol 277, page 563, July 1997). The actions of C-peptide were not simply a reversal of the diabetic process; but were mediated through quite different mechanisms. However the difficulty of transposing this work to humans was that rats do not have the same susceptibility to retinal disease that humans do. Nonetheless, the Eli Lilly Co. sponsored an initial clinical trial with the help of Dr. Julio Santiago at the same University. Unhappily he recently died and as far as I can tell no formal report of the work has been published, although a preliminary account showed no effect when achieving normal levels of C-peptide. No one at this center knew of any other clinical trials nor are there any references in MEDLINE. My guess would be that the preliminary results in man did not offer prospects that were any improvement on current regimens. If and when trials resume, I would not be too optimistic that they would offer much to your 32 year old beyond what good control can do. DO'B Original posting 26 Sep 97

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