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Proinsulin and the proinsulin\u2010to\u2010C\u2010peptide ratio did not associate with variables associated with insulin resistance (\n                      <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>\n                      , triglyceride levels, insulin\/day\/kg). Higher proinsulin\u2010 and C\u2010peptide levels correlated with higher levels of anti\u2010\n                      <jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>\n                      antibodies (Spearman\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.18 and 0.23 respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), but not with anti\u2010\n                      <jats:styled-content style=\"fixed-case\">IA2<\/jats:styled-content>\n                      . A high\u2010risk\n                      <jats:styled-content style=\"fixed-case\">DR3<\/jats:styled-content>\n                      \/3\n                      <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\n                      genotype associated with complete loss of C\u2010peptide (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      0.34, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.14\u20130.79) and proinsulin(\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      0.44, 95% CI 0.20\u20130.92).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\/Interpretation<\/jats:title>\n                    <jats:p>In type 1 diabetes mellitus, proinsulin levels remain detectable long after diagnosis, also in the absence of C\u2010peptide, implying the presence of stressed, yet alive \u03b2\u2010cells.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.16604","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T08:28:51Z","timestamp":1752481731000},"page":"5566-5575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Persisting plasma proinsulin levels in a cohort of 482 individuals with long\u2010standing type 1 diabetes mellitus"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2124-4915","authenticated-orcid":false,"given":"Douwe Frank","family":"de Wit","sequence":"first","affiliation":[{"name":"Department of Experimental Vascular Medicine Amsterdam University Medical Center, University of Amsterdam  Amsterdam the 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