The first and second phase of insulin secretion in naive Chinese type 2 diabetes mellitus

Jiunn Diann Lin, Te Lin Hsia, Chung Ze Wu, Ching Chieh Su, Wen Ya Ma, An Tsz Hsieh, Chang Hsun Hsieh, Kun Wang, Yi Min Chu, Dee Pei

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Impaired insulin secretion (ISEC) has been recognized as one of the most important pathophysiologies of type 2 diabetes mellitus. There are 2 phases of ISEC: the first phase (first ISEC) and second phase (second ISEC). This study aimed to evaluate the 2 phases of ISEC in newly diagnosed type 2 diabetes mellitus patients. Fifty-two drug-naive type 2 diabetes mellitus patients were given 2 tests: a modified low-dose graded glucose infusion (M-LDGGI) and frequent sample intravenous glucose tolerance test. The M-LDGGI is a simplified version of the Polonsky method. Two stages of intravenous infusion of glucose with different rates were given, starting from 2 mg/(kg min) and then followed by 6 mg/(kg min). Each stage was maintained for 80 minutes. The results were interpreted as the slope of the changes of plasma insulin against the glucose levels. The slope of these curves was regarded as the second ISEC and used as the criterion for grouping-the responders and nonresponders. The responders are older and had higher body mass index and log (homeostasis model assessment of β-cell function) (log HOMA-β) but lower fasting plasma glucose and hemoglobin A 1c (HbA 1c) than the nonresponders. Significant correlations were only noted between the second ISEC and first ISEC (r = 0.278, P = .046) and between the second ISEC and log HOMA-β (r = 0.533, P = .000). Correlation between different parameters and HbA 1c was also evaluated. Only second ISEC and log HOMA-β were correlated significantly with HbA 1c (r = -0.388, P = .015 and r = -0.357, P = .026, respectively). In type 2 diabetes mellitus, subjects with higher second ISEC are older and have higher body mass index. At the same time, second ISEC is the most important factor for determining glucose levels in naive Chinese type 2 diabetes mellitus patients. The first and second ISECs were only modestly correlated, which indicated that the deterioration of these 2 phases was not synchronized. Finally, we also recommend using the M-LDGGI for quantifying second ISEC. This practical method could be done in many centers without difficulty.

Original languageEnglish
Pages (from-to)780-786
Number of pages7
JournalMetabolism: Clinical and Experimental
Volume59
Issue number6
DOIs
Publication statusPublished - Jun 2010

Fingerprint

Type 2 Diabetes Mellitus
Insulin
Glucose
Hemoglobin A
Body Mass Index
Glucose Tolerance Test
Intravenous Infusions
Fasting
Homeostasis

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

The first and second phase of insulin secretion in naive Chinese type 2 diabetes mellitus. / Lin, Jiunn Diann; Hsia, Te Lin; Wu, Chung Ze; Su, Ching Chieh; Ma, Wen Ya; Hsieh, An Tsz; Hsieh, Chang Hsun; Wang, Kun; Chu, Yi Min; Pei, Dee.

In: Metabolism: Clinical and Experimental, Vol. 59, No. 6, 06.2010, p. 780-786.

Research output: Contribution to journalArticle

Lin, Jiunn Diann ; Hsia, Te Lin ; Wu, Chung Ze ; Su, Ching Chieh ; Ma, Wen Ya ; Hsieh, An Tsz ; Hsieh, Chang Hsun ; Wang, Kun ; Chu, Yi Min ; Pei, Dee. / The first and second phase of insulin secretion in naive Chinese type 2 diabetes mellitus. In: Metabolism: Clinical and Experimental. 2010 ; Vol. 59, No. 6. pp. 780-786.
@article{76f1a31c9e234b2f8b795c86978b246a,
title = "The first and second phase of insulin secretion in naive Chinese type 2 diabetes mellitus",
abstract = "Impaired insulin secretion (ISEC) has been recognized as one of the most important pathophysiologies of type 2 diabetes mellitus. There are 2 phases of ISEC: the first phase (first ISEC) and second phase (second ISEC). This study aimed to evaluate the 2 phases of ISEC in newly diagnosed type 2 diabetes mellitus patients. Fifty-two drug-naive type 2 diabetes mellitus patients were given 2 tests: a modified low-dose graded glucose infusion (M-LDGGI) and frequent sample intravenous glucose tolerance test. The M-LDGGI is a simplified version of the Polonsky method. Two stages of intravenous infusion of glucose with different rates were given, starting from 2 mg/(kg min) and then followed by 6 mg/(kg min). Each stage was maintained for 80 minutes. The results were interpreted as the slope of the changes of plasma insulin against the glucose levels. The slope of these curves was regarded as the second ISEC and used as the criterion for grouping-the responders and nonresponders. The responders are older and had higher body mass index and log (homeostasis model assessment of β-cell function) (log HOMA-β) but lower fasting plasma glucose and hemoglobin A 1c (HbA 1c) than the nonresponders. Significant correlations were only noted between the second ISEC and first ISEC (r = 0.278, P = .046) and between the second ISEC and log HOMA-β (r = 0.533, P = .000). Correlation between different parameters and HbA 1c was also evaluated. Only second ISEC and log HOMA-β were correlated significantly with HbA 1c (r = -0.388, P = .015 and r = -0.357, P = .026, respectively). In type 2 diabetes mellitus, subjects with higher second ISEC are older and have higher body mass index. At the same time, second ISEC is the most important factor for determining glucose levels in naive Chinese type 2 diabetes mellitus patients. The first and second ISECs were only modestly correlated, which indicated that the deterioration of these 2 phases was not synchronized. Finally, we also recommend using the M-LDGGI for quantifying second ISEC. This practical method could be done in many centers without difficulty.",
author = "Lin, {Jiunn Diann} and Hsia, {Te Lin} and Wu, {Chung Ze} and Su, {Ching Chieh} and Ma, {Wen Ya} and Hsieh, {An Tsz} and Hsieh, {Chang Hsun} and Kun Wang and Chu, {Yi Min} and Dee Pei",
year = "2010",
month = "6",
doi = "10.1016/j.metabol.2009.09.024",
language = "English",
volume = "59",
pages = "780--786",
journal = "Metabolism: Clinical and Experimental",
issn = "0026-0495",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - The first and second phase of insulin secretion in naive Chinese type 2 diabetes mellitus

AU - Lin, Jiunn Diann

AU - Hsia, Te Lin

AU - Wu, Chung Ze

AU - Su, Ching Chieh

AU - Ma, Wen Ya

AU - Hsieh, An Tsz

AU - Hsieh, Chang Hsun

AU - Wang, Kun

AU - Chu, Yi Min

AU - Pei, Dee

PY - 2010/6

Y1 - 2010/6

N2 - Impaired insulin secretion (ISEC) has been recognized as one of the most important pathophysiologies of type 2 diabetes mellitus. There are 2 phases of ISEC: the first phase (first ISEC) and second phase (second ISEC). This study aimed to evaluate the 2 phases of ISEC in newly diagnosed type 2 diabetes mellitus patients. Fifty-two drug-naive type 2 diabetes mellitus patients were given 2 tests: a modified low-dose graded glucose infusion (M-LDGGI) and frequent sample intravenous glucose tolerance test. The M-LDGGI is a simplified version of the Polonsky method. Two stages of intravenous infusion of glucose with different rates were given, starting from 2 mg/(kg min) and then followed by 6 mg/(kg min). Each stage was maintained for 80 minutes. The results were interpreted as the slope of the changes of plasma insulin against the glucose levels. The slope of these curves was regarded as the second ISEC and used as the criterion for grouping-the responders and nonresponders. The responders are older and had higher body mass index and log (homeostasis model assessment of β-cell function) (log HOMA-β) but lower fasting plasma glucose and hemoglobin A 1c (HbA 1c) than the nonresponders. Significant correlations were only noted between the second ISEC and first ISEC (r = 0.278, P = .046) and between the second ISEC and log HOMA-β (r = 0.533, P = .000). Correlation between different parameters and HbA 1c was also evaluated. Only second ISEC and log HOMA-β were correlated significantly with HbA 1c (r = -0.388, P = .015 and r = -0.357, P = .026, respectively). In type 2 diabetes mellitus, subjects with higher second ISEC are older and have higher body mass index. At the same time, second ISEC is the most important factor for determining glucose levels in naive Chinese type 2 diabetes mellitus patients. The first and second ISECs were only modestly correlated, which indicated that the deterioration of these 2 phases was not synchronized. Finally, we also recommend using the M-LDGGI for quantifying second ISEC. This practical method could be done in many centers without difficulty.

AB - Impaired insulin secretion (ISEC) has been recognized as one of the most important pathophysiologies of type 2 diabetes mellitus. There are 2 phases of ISEC: the first phase (first ISEC) and second phase (second ISEC). This study aimed to evaluate the 2 phases of ISEC in newly diagnosed type 2 diabetes mellitus patients. Fifty-two drug-naive type 2 diabetes mellitus patients were given 2 tests: a modified low-dose graded glucose infusion (M-LDGGI) and frequent sample intravenous glucose tolerance test. The M-LDGGI is a simplified version of the Polonsky method. Two stages of intravenous infusion of glucose with different rates were given, starting from 2 mg/(kg min) and then followed by 6 mg/(kg min). Each stage was maintained for 80 minutes. The results were interpreted as the slope of the changes of plasma insulin against the glucose levels. The slope of these curves was regarded as the second ISEC and used as the criterion for grouping-the responders and nonresponders. The responders are older and had higher body mass index and log (homeostasis model assessment of β-cell function) (log HOMA-β) but lower fasting plasma glucose and hemoglobin A 1c (HbA 1c) than the nonresponders. Significant correlations were only noted between the second ISEC and first ISEC (r = 0.278, P = .046) and between the second ISEC and log HOMA-β (r = 0.533, P = .000). Correlation between different parameters and HbA 1c was also evaluated. Only second ISEC and log HOMA-β were correlated significantly with HbA 1c (r = -0.388, P = .015 and r = -0.357, P = .026, respectively). In type 2 diabetes mellitus, subjects with higher second ISEC are older and have higher body mass index. At the same time, second ISEC is the most important factor for determining glucose levels in naive Chinese type 2 diabetes mellitus patients. The first and second ISECs were only modestly correlated, which indicated that the deterioration of these 2 phases was not synchronized. Finally, we also recommend using the M-LDGGI for quantifying second ISEC. This practical method could be done in many centers without difficulty.

UR - http://www.scopus.com/inward/record.url?scp=77952247297&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952247297&partnerID=8YFLogxK

U2 - 10.1016/j.metabol.2009.09.024

DO - 10.1016/j.metabol.2009.09.024

M3 - Article

C2 - 20005535

AN - SCOPUS:77952247297

VL - 59

SP - 780

EP - 786

JO - Metabolism: Clinical and Experimental

JF - Metabolism: Clinical and Experimental

SN - 0026-0495

IS - 6

ER -