Short-Term Intensive Therapy in Newly Diagnosed Type 2 Diabetes Partially Restores Both Insulin Sensitivity and {beta}-Cell Function in Subjects With Long-Term Remission Full Text
Diabetes Care, 06/17/2011
Hu Y et al. – Intensive glycemic control therapy (IT) in newly diagnosed type 2 diabetes not only partially restored β–cell function but also greatly restored insulin sensitivity. Compared with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT) subjects, β–cell function was less restored than insulin sensitivity after IT in the remission subjects.
Methods- Forty–eight newly diagnosed type 2 diabetic patients were randomly assigned to IT for 2 weeks and followed–up for 1 year.
- Intravenous glucose tolerance tests were conducted in NGT, IGT, and diabetic subjects.
- Blood glucose and insulin were measured before and after IT and at the 1–year follow–up.
- IT lowered the homeostasis model assessment (HOMA) for insulin resistance (IR) significantly, from 3.12 ± 1.4 (mean ± SD) to 1.72 ± 0.8, a level comparable to the IGT (1.96 ± 1.1) and NGT (1.37 ± 0.6) subjects in the remission group; however, no HOMA–IR improvement was observed in nonremission subjects.
- HOMA–β in the remission group was improved (mean, interquartile range) from 18.4 (8.3–28.5) to 44.6 (32.1–69.1) and acute insulin response of insulin (AIRins) from 1.50 ± 0.22 to 1.83 ± 0.19 μIU/mL after IT, but was still significantly lower than those in NGT individuals (HOMA–β: 86.4 [56.7–185.2], P < 0.01; AIRins: 2.54 ± 0.39 μIU/mL, P < 0.01).
- After IT and at 1 year, the hyperbolic relationship between HOMA–β and HOMA sensitivity of remission subjects shifted close to that of IGT subjects.
