A type 1 diabetic mystery is why do some Type 1s get complications and others seem to never get them? A massive Japanese study of Type 1 diabetics found that those with fulminant diabetes developed complications much faster and more severely than those with non-fulminant diabetes.

The difference between fulminant and non-fulminant is the speed and intensity at which the disease develops. Fulminant Type 1 diabetes typically develops suddenly with near total loss of beta cell function. This type of diabetes is confirmed with testing c-peptide levels. Non-fulminant type 1 diabetes has residual c-peptide levels that eventually taper to undetectable. Sometimes this is seen through many years of the Honeymoon Period.

This study may be the antithesis of conventional wisdom for preventing complications. Staking all hopes on blood sugar control is heavily optimistic. Yes controlling blood sugar does lessen the workload for existing beta cells, and thus extends the lifespan of each beta cell. Research suggests that c-peptide offers protection to beta cells, both from apoptosis (cell death) and encourages new cell growth. This new cell growth applies to beta cells and other cells of the body that endure long-term Type 1 diabetes complications.

Diabetics are instructed that maintaining normal blood sugars is the Holy Grail of preventing long-term complications. Yes and no. The truth is controlling your blood sugar will not allow complications of Type 1 diabetes to develop as quickly, presuming you still had some level of beta cell function upon diagnosis (i.e., c-peptide). That doesn't sound like a reward as much as it does a delayed punishment. I'd like c-peptide with my insulin, please. It's off the à la carte menu? That's fine - serve it up! I want to thank Klausen for bringing this study to my attention.

It's logical that the Nation is up-in-arms about putting genetically modified meats and produce on the shelves in grocery stores and getting due diligence from the government for it. It makes a lot of sense to test something you will use to fuel your body before it is permitted to penetrate the market. So how did genetically modified human insulin overtake the market again? Oh - there must not be any side effects like a diabetes epidemic or something crazy like that, right?

But I digress on the topic in honor of springtime, when "love is in the air". As we all know, love is one of the strongest forces of nature. So is it fair that it went unnoticed by the FDA that human synthetic insulin results in a loss of awareness of hypoglycemia, among other natural responses to hormonal precursors? This is due to a significant suppression of tachycardia.

Tachycardia refers to a rapid beating of the heart. This event may be a perfectly normal response to stress. A stressful event may cause the endocrine system to release hormones that regulate body functions related to mood, growth and development, tissue function, and metabolism, all of which are governed by blood sugar. The hormone that is critically important in tachycardia is epinephrine (adrenaline).

Epinephrine is a fight or flight hormone which is released from the adrenal glands when danger threatens (hypoglycemia, mating rituals, survival of the fittest). When secreted into the bloodstream, it rapidly prepares the body for action in emergency situations. The hormone boosts the supply of oxygen and energy-giving glucose to the brain and muscles; some bodily processes not vital to the response are suppressed. This is exactly what happens when animals become twitterpated in the spring (Bambi, Walt Disney - 1942).

As the birds and the bees go about their business, pollinating and procreating - I ask you think about the adulterated pharmacological intervention that has impaired such a natural phenomenon as love. Celebrate the body's natural response to tachycardia, and realize that our Creator made us perfectly. The longer you spend in the lab genetically modifying His work - the more you are fighting the forces of nature. Now please, put it back the way you found it.

Like a student driver -- the function of proinsulin (c-peptide) is as critically important as driver's education. The research was done, but because the information highway was just picking up speed (at the time back in '88) dissemination of such research was difficult, at best. Never fear - I found a good study to start things rolling.

Proinsulin (c-peptide) is made along with insulin in a 1 to 1 ratio from the beta cells. After a dose of proinsulin was administered - it took 5 to 10 minutes longer to lower a patient's blood sugar in comparison to insulin, alone. The rise of blood sugar following the lowest point was much slower, as well. In lay terms this means that insulin, coupled with proinsulin (c-peptide), results in a more controlled reaction. Kind of like the teenager with his permit to drive and Dad riding shotgun. The permit gives the kid the right to drive the car, but Dad is telling the kid when to accelerate and when to slow down. Insulin and proinsulin are quite similar in nature except we're talking about a life threatening hormone without the parental guidance.

The antilipolytic effect of proinsulin (tapping fat cells for energy and ANTI means this is stopped) was significantly stronger in comparison to insulin alone. Human proinsulin has a stronger effect on prevention of fat burning for energy in the absence of insulin (ketoacidosis). This seems logical because if you metabolize the glucose in your blood for energy - you will have little (if any) residual glucose to store as fat. Type 2 diabetics have a plethora of c-peptide in their body upon diagnosis but their blood sugar is also high. Looks like insulin and proinsulin reduces the risk of ketoacidosis and regulates fat metabolism.

Why did they decide to manufacture human synthetic insulin without it again? A personal experience pumping piggy proinsulin for 2 days now and I've seen definite control in my blood sugar fluctuations - less than 20 mg/dL in any testing window. It feels like the newly introduced highly purified porcine proinsulin came with a built-in continuous glucose monitor (i.e., C-peptide). More to come...

While patrolling the PubMed database this weekend, I came across a very interesting study that investigated the effects of new insulins on insulin and C-peptide antibodies, insulin dose, and diabetic control. Please note - this study was published in 1983. After reading -- I invite EVERYONE to let me know if it is possible to get purified pork insulin and whether or not you have been on it-- and if you have seen a difference in your diabetes control. Please?

24 diabetic patients using bovine (beef) insulin and possessing insulin antibodies underwent a study of the immunological and clinical consequences of changes in both purity and species of their insulin. The new insulin regimes tested were one of three: a) purified bovine insulin, b) highly purified porcine insulin, and c) semisythetic human insulin.

The patients underwent 3 consecutive 4-month periods on each insulin regimen. The average insulin antibody levels changed little on purified bovine (beef) insulin; actually increased on semi-synthetic human insulin but fell substantially on highly purified porcine insulin. Okay - so this means, in lay terms that the patient's insulin antibodies (the stuff killing your islets) remained relatively the same on beef insulin but became categorically HIGH on synthetic human insulin. And most importantly - to me-the highly purified porcine insulin actually DROPPED the insulin antibodies. Of course - it would cost big pharmaceutical companies more to manufacture highly purified porcine insulin.

C-peptide antibodies fell significantly and continuously throughout the study. The slower rate of fall in C-peptide antibody levels is likely to be due to the prolonged half-life of circulating exogenous proinsulin in the presence of insulin antibody. Although insulin dose remained constant the incidence of hypoglycaemic episodes did not increase and glycosylated haemoglobin levels rose significantly when patients were on porcine insulin. The deterioration in diabetic control may have been due to greater temporal mismatch between insulin needs and insulin availability with pork or human insulin than with beef insulins, and to reduced insulin antibody levels.

The use of purer insulins which more closely resemble the human form can cause a significant reduction in levels of insulin and C-peptide antibodies. These changes may not necessarily produce better diabetic control. Recent studies have shown that a depletion of C-peptide in the body results in a greater chance of microvascular complications associated with diabetes.

This study was published around the time when all of the synthetic human insulins were sweeping the Nation. I tried calling my local CVS Pharmacy on Saturday morning to see if I could get some purified porcine insulin. No such luck. Go figure. The big guys were successful at convincing the medical community and patients that no other insulin is better. Correction - no other insulin is cheaper to manufacture and that means it is better for them. And the importance of C-peptide was overlooked entirely - or was it? C-peptide prevents the complications associated with injecting insulin - but that sounds like another marketable drug. After all - synthetic human insulin doesn't have C-peptide. REAL HUMAN INSULIN does (the way it comes out of the beta cells, in natural form, it does)!!! And as long as your body is producing insulin antibodies - you NEED their synthetic insulin (conveniently -- the only kind you can buy). Best business model - customer for life!

"Cure. Care. Commitment. These are the words we live by at the American Diabetes Association."

Blah, blah, blah......Those are the words you will hear when you call the ADA hotline and tell them their indifference and apathetic resolve to push for C-peptide trials is atrocious. (If you choose to do so, of course -- details to follow.)

After I blogged yesterday about the ADA colossal let-down -- I neglected to tell you how we can lend guidance to the ADA mission. It is apparent they do not know how to make good use of their 501(c)3 for the sake of cure, care and commitment to diabetes. No worries, ADA - millions of diabetics are here to help you understand our needs.

Contact the American Diabetes Association at 1-800-DIABETES and tell them:

ALLIE BEATTY of The Diabetes Blog told us that you were NOT going to encourage your big pharmaceutical sponsors to start clinical trials for C-peptide. We need this to prevent and reverse complications from the disease...

From there the floor is yours to proceed. Their hours of operation are Monday - Friday, 8:30 AM - 8 PM Eastern Standard Time.

Please call and tell them you want C-peptide. When labs began making insulin they didn't make it with C-peptide. You want it! You deserve it! But most importantly -- you need it!

A report published in Diabetes Care says C-peptide improves sensory nerve function in type 1 diabetic patients with early-stage diabetic neuropathy. Thanks to Scott Strumello's comment, earlier today, I couldn't help but query the world wide web for more information on this C-peptide revelation. If I forget to mention it - thanks a million, Scott!

C-peptide was shown to be a significant factor in the maintenance of microvascular function. In a 6 month study of type 1 diabetes patients receiving replacement C-peptide, their nerve functions improved remarkably. A randomized study of 139 patients received one of 3 daily treatments: 1.5 mg of C-peptide, 4.5 mg of C-peptide, or placebo. At the beginning of the study, the sensory and motor nerve conduction velocities were significantly reduced compared with normal. After 6 months of treatment, peak sensory nerve conduction velocities improved in the groups treated with low-dose or high-dose C-peptide, but not significantly compared with the control group. The study showed a significant advantage in nerve functions for those treated with C-peptide (37%) verses those in the control group (19%). Overall, there were no adverse drug reactions reported from treatment of C-peptide.

At this time, there is strong evidence supporting the belief that C-peptide may be beneficial not only for nerve function, but also for the treatment and prevention of other long-term complications caused by type 1 diabetes such as nephropathy and perhaps retinopathy. Phase II clinical studies are ongoing at this time to demonstrate the safety and efficacy of C-peptide replacement therapy for the treatment of diabetic peripheral neuropathy. I can hear the trumpets playing already. I'll be right there with pen-in-hand ready to sign the dotted line for such a study. Thank you, Scott and thank you, Creative Peptides.