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Experimental Diabetes Research
Volume 2008 (2008), Article ID 176245, 8 pages
Review Article

Role of C-Peptide in the Regulation of Microvascular Blood Flow

1Medical Department, Institute for Clinical Research and Development, 55116 Mainz, Germany
2Department of Endocrinolgy and Metabolism, Johannes Gutenberg University, 55131 Mainz, Germany
3Diabetes Centre, 13187 Berlin, Germany

Received 29 November 2007; Accepted 23 June 2008

Academic Editor: George King

Copyright © 2008 T. Forst et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


During the recent years, the role of C-peptide, released from the pancreatic beta cell, in regulating microvascular blood flow, has received increasing attention. In type 1 diabetic patients, intravenous application of C-peptide in physiological concentrations was shown to increase microvascular blood flow, and to improve microvascular endothelial function and the endothelial release of NO. C-peptide was shown to impact microvascular blood flow by several interactive pathways, like stimulating ATPase or the endothelial release of NO. There is increasing evidence, that in patients with declining beta cell function, the lack of C-peptide secretion might play a putative role in the development of microvascular blood flow abnormalities, which go beyond the effects of declining insulin secretion or increased blood glucose levels.