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 A1c (HbA1c) 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 HbA1c was also evaluated. Only second ISEC and log HOMA-β were correlated significantly with HbA1c (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 A1c (HbA1c) 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 HbA1c was also evaluated. Only second ISEC and log HOMA-β were correlated significantly with HbA1c (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.
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U2 - 10.1016/j.metabol.2009.09.024
DO - 10.1016/j.metabol.2009.09.024
M3 - Article
C2 - 20005535
AN - SCOPUS:77952247297
SN - 0026-0495
VL - 59
SP - 780
EP - 786
JO - Metabolism: Clinical and Experimental
JF - Metabolism: Clinical and Experimental
IS - 6
ER -
