The effects of short-term continuous subcutaneous insulin infusion treatment on beta-cell function in newly diagnosed type 2 diabetic patients

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CHINESE JOURNAL OF DIABETES
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Volume 11, Issue 01, 2003
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Abstract: Objective To evaluate the effect of short term continuous subcutaneous insulin infusion (CSII) treatment on plasma glucose and beta cell function in newly diagnosed type 2 diabetic patients with severe hyperglycemia. Methods Thirty six newly diagnosed type 2 diabetic patients with FPG>11.1 mmol/L were treated by 2 weeks CSII. An intravenous glucose tolerance test (IVGTT) was performed before and after CSII. Fasting plasma glucose (FPG), 2 hours postprandial glucose (2 hPG), glycosylated hemoglobin A 1c (GHbA 1C ), proinsulin, lipid profiles, insulin, and C peptide during IVGTT were measured. The results of FPG, 2hPG, GHbA1C, first phase insulin secretion, the mean area under the curve (AUC) of insulin and C peptide, proinsulin, proinsulin/insulin ratio, Homa β and Homa IR were compared. Results The excellent control of FPG and 2hPG in 35 out of 36 patients were achieved stably in 2.7±1.9 days and 8.5±3.5 days by CSII. After 2 weeks CSII intensive treatment, beta cell function was dramatically improved: the first phase insulin secretion of most patients was restored in different degrees, the sharp peaks of insulin release were seen in some patients. The mean AUC of insulin and C peptide and Homa β were significantly increased; plasma proinsulin, proinsulin/insulin ratio and Homa IR were decreased. Conclusion The excellent glycemic control and improvement of beta cell function can be induced by short term CSII intensive therapy in newly diagnosed type 2 diabetic patients with severe hyperglycemia.

  • [1]Purrello F, Rabuazza AM. Metabolic factors that affect beta-cell function and survival. Diabet Nutr Metab, 2000,13: 84-91.
  • [2]Sivitz WI. Lipotoxicity and glucotoxicity in type 2 diabetes. Effects on development and progression. Postgrad Med,2001,109: 55-59,63-64.
  • [3]Lenhard MJ, Reeves GD. Continous subcutaneous insulin infusion: a comprehensive review of insulin pump therapy. Arch Intern Med,2001,161: 2293-2300.
  • [4]Dupuy O, Mayaudon H, Palou M, et al. Optimized transient insulin infusion in uncontrolled type 2 Diabetes: Evaluation of a pragmatic attitude. Diabet Med, 2000,26: 371-375.
  • [5]Valensi P, Moura I, Magoarou M,et al. Short-term effects of continuous subcutaneous insulin infusion treatment on insulin secretion in non-insulin-dependent overweight patients with poor glycaemic control despite maximal oral anti-diabetic treatment. Diabet Metab,1997,23: 51-57.
  • [6]Lormeau B, Aurousseau MH, Valensi P, et al. Hyperinsulinemia and hypofibrinolysis: effects of short-term optimized glycemic control with contineuous insulin infusion in type II diabetic patients. Metabolism,1997,46: 1074-1079.
  • [7]Ilkova H, Glaser B, Tunckale A, et al. Induction of long-term glycemic control in newly diagnosed type 2 diabetic patients by transient intensive insulin treatment. Diabetes Care,1997,20: 1353-1356.
  • [8]Pratley RE, Weyer C. The role of impaired early insulin secretion in the pathogenesis of type II diabetes mellitus. Diabetologia 2001,44:929-945.
  • [9]Del Prato S, Marchetti P, Bonadonna RC. Phasic insulin release and metabolic regulation in type 2 diabetes. Diabetes,2002, 51suppl 1: s109-116.
  • [10]Kahn SE. The importance of the beta-cell in the pathogenesis of type 2 diabetes mellitus. Am J Med, 2000,108suppl 6a: 2s-8s.
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