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

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• 作者：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
• 刊名：Metabolism
• 出版年：2010
• 出版时间：June 2010
• 年：2010
• 卷：59
• 期：6
• 页码：780-786
• 全文大小：376 K

文摘

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.