Abstract
The proportion of total plasma immunoreactive insulin comprising the proinsulin-like component was determined in 5 diabetic subjects manifesting fasting hyperglycemia, severe glucose intolerance, and insulinopenia, and also in one insulinopenic patient both before and after removal of a phaeochromocytoma. The proinsulin-like component comprised a mean of 37% (range 30–50%) of the total immunoreactive insulin in the basal state, 27% (range 20–32%) at 15 min, and 32% (range 23–50%) 120 min after 100g of oral glucose. These values are significantly higher than in normal subjects or patients with hyperinsulinemic responses (excepting patients with insulinoma). Our studies suggest that diseases that affect the B-cell's ability to store insulin or prevent the secretory granule of the B-cell from undergoing full maturation will be associated with an increased secretion from immature granules, that contain a higher percentage of proinsulin-like components. The proportion of the total immunoreactive insulin comprising the proinsulin-like component is, therefore, a reflection of the integrity of the B-cell granule.
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