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2023
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Type 1 diabetes Brittle diabetes IDDM (Disease) Ketosis prone diabetes Diabetes mellitus Insulin-dependent diabetesCiter ce document
Katia Carvalho Alves et al., « Proinsulin: Physiology, testing, and clinical applications », Annales de Biologie Clinique, ID : 10670/1.ac8b6e...
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The proinsulin molecule results from the cleavage of preproinsulin, produced in pancreatic beta cells. Its cleavage allows the release of insulin, the key hormone in glycemia regulation, and of C-peptide in equimolar amounts. During a fasting test, an insulinoma diagnosis is the result of overly high levels of insulin and C-peptide concomitant with hypoglycemia. In cases where there is a discrepancy between the two parameters, it can be interesting to conduct a proinsulin assay. In the case of diabetes, endoplasmic reticulum stress and beta cell inflammation lead to the secretion of misfolded proinsulin molecules. Thus, in the case of type 2 diabetes, the proinsulin/insulin ratio increases with the degree of insulin resistance. In the case of type 1 diabetes, the proinsulin/C-peptide ratio could predict the onset of diabetes in relatives. In our practice, serum proinsulin determined using an ELISA immunoassay (Millipore®) during a fasting test can be complementary to C-peptide and insulin assays to identify hypoglycemia. In cases of glucose intolerance and diabetes, proinsulin could thus be measured.
