Is Insulin Enough?...C-Peptide Replacement Therapy

Cebix Inc. is a company that began in Sweden and is now operating in San Diego.

"Cebix has developed an injectable formulation of C-peptide that it hopes to market for treatment of type 1 diabetes. Ultimately, Cebix believes that the sensory nervous system improvements seen in studies warrants replacement therapy for all type 1 diabetics...".

"Throughout the course of the research into C-peptides, a total of nineteen clinical studies have been carried out with about 300 patients, and the initial results indicate that C-peptide increases nerve conduction and perception of vibration in both humans and animals."

"Cebix is currently looking at two options that would require only one weekly injection from a 27-gauge-or-smaller needle. The once-a-week delivery, Cebix hopes, will mean that the potential benefits of the drug for patients with neuropathy– and perhaps eventually for all type 1 diabetics– will outweigh the pain and hassle of taking another shot."

"Cebix hopes to move forward with clinical trials for C-peptide replacement therapy in diabetic neuropathy, and then to continue with trials for treatment of diabetic nephropathy and other complications. It will still be several years at the least, then, before Cebix has any C-peptide commercially available, and until that time they will be testing the efficacy and safety of the treatment. Nonetheless, the emerging picture for diabetics is clear– insulin isn’t the only color in the crayon in the box anymore, and Cebix and others are working hard to supply diabetics with the missing colors."

There are some that believe that there is evidence that c-peptide may actually have negative effects ( I wonder what sort of hurdles will be required by the FDA on this one.

I think there is strong evidence that diabetes (be it T1, or T2) is more than just a disease about blood sugars. Sure, that’s a well known symptom, but there are more fundamental inflammations or immune system issues that are at the root cause and disrupt other systems in the body.

As we get better at controlling bg, the next frontier will be finding these other issues (many perhaps poorly defined at this point) which are not defeated just by controlling bg, and treating them. C-peptide, then other things. Or maybe, someday, a cure, not just treatments?

Jeeny’s blog inidicates that high levels of naturally secreted insulin and concomittant high c-peptides,seen in insulin resistant type two diabetes, can cause inflammation, plaque build up, that may be the root of heart disease. I do not see how this would correlate to negative consequences of injected c-pepetides in those of use who are insulin and c-peptide defcient: No naturally secreted-peptides nor insulin, and have no markers of inflammation. That is me: C-reactive protein is ,02, minmal risk of heart disease due to inflammation. This can be true of many type ones… I would gladly take a c-peptide shot once weakly to reduce my mild to moderate, on and off neuropathic symptoms; and possibly as a protective effect from hyperglycemia. I took beef and pork insulins for over 20 years and did not have any ill long-term effects from them, and they were filled with c-peptides.

God bless,


Thanks again Richard for that info I posted it on Facebook.

My point was that there appears to be some evidence that higher levels of c-peptide cause problems. How do you know if you are getting a perfect level of c-peptide or one which is going to cause problems. If the differnece is only 25% in a level that is a razor thin margin for error. Most medications have a wide range of dosing where they work and toxic effects normally require major overdosing, apparently such safety may not be available with c-peptide.

Where bsc, did you read that there is only a 25% margin of error for c-pepetide dosing? What I read seemed to indicate that this would be a margin of error for those who already have naturally secreted levels of insulin and c-pepetide, Not for those of us who already have none. Jenny’s warnings seemed to be targeted at not giving sulynoreas to stimulate insulin production or other drugs to desensitize type twos who already have high insulinproduction, in order to avoid the possibility of heart attack risk.

I do not believe there is a risk for those of us who do not have ANY level of naturally secreted c-peptides. She actually WAS advocating insulin, which currently has no c-pepetide , as an initial attempt to reign in blood sugar for newly diagnosed type 2;s. Her comments and articles were about treatment paradigms for type 2’s.

She does mention the desires for type ones to have c-pepetide as a treatment,and mentioned those who advocate adding c-peptides to insulin . She does not want this in all types of insulin because it may not be good FOR TYPE TWOS!!! Look at what she wrote. I have highlighted my point:If your insulin production is dropping and you are insulin resistant, this data suggests you might better off injecting insulin rather than using a drug like Glyburide, Amaryl, or Prandin to stimulate more native insulin–and C-peptide-- production. The explanation for why these insulin stimulating drugs appear to raise the incidence of heart attack has focused on their ability to stimulate receptors on the heart. And since newer drugs in these families don’t target the heart receptor, it has been argued they are safer. But this new finding about C-peptide makes me wonder if it is the C-peptide they stimulate causing heart problems too.

Nuff said. Extra c-peptide is for type 1’s, not type 2’s is my take on the articles cited.

God Bless,


You misunderstood my comment. Why would large c-peptides be good for type 1s and not be for the rest of the population? There is as much evidence that c-peptide harms as there is that it helps.
If c-peptide levels just above normal are harmful, then c-peptide therapy may be risky (for type 1s).

Large c-peptide levels in Naturally secreted insulin that type two’s already have , does not need to supplemented… that is why it is risky… . Those of us with no naturally secreted Cp pepetides are the ones I see who are not at risk, such as type 1 or type 1.5 ( both would need to be tested to make sure they have no c-peptides before treatment)… Just my honest opinion. Please cite the evidence that it is harmful at levels at normal or just above normal for those of us who do not have any exisitng c-peptide? If no studies have been done examining this, then I I will volunteer to take part in one…

God Bless,


I guess I wasn’t clear. Elevated levels of c-peptide have been found to cause thickening of arteries in humans and animals. Unfortunately, that includes T1s. T1s are special, but not “that” special. I am expressing caution that while there may be real benefits, there may also be some serious downside risks (for T1s).

I think the idea is that c-peptide would be replaced for T1s who have no (or virtually no) insulin/c-peptide production, therefore it would not be elevated levels of c-peptide present, simply “normal” levels. Even if a T1 became insulin resistant and needed to take large amounts of insulin, assuming c-peptide was given in a separate injection there wouldn’t be a need to increase the amount of c-peptide taken. If really worried you could even err on the side of caution and give low doses to T1s, so they could get any benefits of it without the risk of getting too much. This would be impossible to do for Type 2s, though, because a majority of Type 2s who take insulin still produce some insulin/c-peptide of their own, so even giving a low dose to them could be too much when it’s added to what they already have.

Thanks Jennifer, I agree with you!

This is gonna screw up anyone on a pump who wants medicare to pay for a pump because c-peptide = not bad enough for a pump (and a type 2)… Honestly i think that small amounts of c-pep might be benificial in type 1s but would just be dangerous in type 2s who have preexisting c-pep,

Thanks from me, Jennifer, for a more explicit explanation.The truth is that there ARE fundamental differences in the both the presentation and the treatment of diabetes in Type one and Type two. In terms of c-peptide as a supplemental injected treatment, I believe that the benefits outweigh the risks for TYPE ONES. I am not trying to be devisive according to type; just attempting to be accurate in my assumptions and postulations about this matter.

God Bless,


Type one 42 years

I am involved with this clinical trial and will let you all know how it turns out for me. I have mild foot neuropathy after 52 years T1D. My Dr and the study Dr. will keep very close track of any plaque issues that might come up. Wish me luck!

Thanks Richard & Linda, I look forward to see if this will help you or not. I feel like I may be getting neuropathy even though my a1c is good etc. It would be nice if there is something else that can help us. I read about cebix already but then forgot and assumed it would never happen here.

good luck!!

I had not seen Jake's reply, but I agree with him. Too much c-pep can be harmful, so T2D's should not receive c-pep injections.

Thanks for your reply Linda. I do hope the c-pep injections will prove beneficial for you.

Do you have the 50 year Joslin medal? There is a group on Facebook called "The Joslin Medalists". It is a group where every member is a long term T1 diabetic who has the medal. If you are interested and are on Facebook contact me (Richard Vaughn) and I can add you to the group.

I wish you the best Linda.

hi Richard. Yes I have my medal and am a member of the medalist group on FB. thank you.