Effect of insulin glargine on endogenous insulin secretion and beta-cell function in Japanese type 2 diabetic patients using oral antidiabetic drugs

Endocrine Journal

Yoshiyuki Sada¹  Mariko Murakami¹  Akio Ohta¹  Katura Murayama¹  Ami Nishine¹  Yasushi Tanaka¹  Hiroyuki Kato¹  Takuyuki Katabami¹  Yoshio Nagai¹  Eriko Hashimoto¹  Shiko Asai¹  Toshihiko Ohshige¹  Takehiro Kawata¹ 

[1] Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan

关键词: Type 2 diabetes;    Insulin glargine;    Proinsulin/C-peptide ratio;    Free fatty acids;   

DOI  :  10.1507/endocrj.EJ13-0304

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(18)Cited-By(1)The aim of the present study was to evaluate the effect of insulin glargine (Gla) (as part of basal-supported oral therapy) on endogenous insulin secretion and beta-cell function in type 2 diabetic patients.In 33 insulin-naive patients showing poor glycemic control on treatment with sulfonylurea (SU)-based OADs without DPP4 inhibitors, once-daily injection of Gla was added without changing OADs, and the dose of Gla was titrated to attain a fasting plasma glucose (FPG) <110 mg/dL over 24 weeks.Morning meal tests were done at baseline, 12 weeks and 24 weeks.FPG and 2-hour plasma glucose (2HPG) and serum C-peptide (FCPR and 2HCPR) were measured 3 times, while serum intact proinsulin (FPI and 2HPI) was measured at baseline and 24 weeks.Levels of FPG, FCPR, 2HPG, and HbA1c were significantly reduced from baseline at 24 weeks (176±52 to 117±27 mg/dL, p<0.01; 2.0±0.9 to 1.6±1.0 ng/mL, p<0.01; 257±53 to 202±27 mg/dL, p<0.01; and 8.4±0.9 to 7.3±0.6%, p<0.01, Mean±SD), but 2HCPR was unchanged.The patients were divided into two groups depending on whether FPG at 24 weeks was <110 mg/dL or not: attained group (n=15) and not attained group (n=18).The dose of Gla did not differ between the two groups, but the 2HPI/2HCPR ratio at 24 weeks showed a significant decrease from baseline in the attained group.Supplementation with Gla improved glycemic control and maintained intrinsic basal insulin secretion, without changing 2-hour postprandial secretion.Achieving good glycemic control with an FPG<110 mg/dL by adding Gla decreased the 2HPI/2HCPR ratio at 24 weeks.

【 授权许可】

Unknown