Recovery of β-Cell Functions with Low-Dose Insulin Therapy: Study in Newly Diagnosed Type 2 Diabetes Mellitus Patients

2011 ◽  
Vol 13 (4) ◽  
pp. 461-465 ◽  
Author(s):  
Saptarshi Bhattacharya ◽  
Ariachery C. Ammini ◽  
Viveka Jyotsna ◽  
Nandita Gupta ◽  
Sadanand Dwivedi
2016 ◽  
Vol 101 (2) ◽  
pp. 572-580 ◽  
Author(s):  
Sharmistha Roy Chowdhury ◽  
Rebecca L. Thomas ◽  
Gareth J. Dunseath ◽  
Rajesh Peter ◽  
D. Aled Rees ◽  
...  

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1837 ◽  
Author(s):  
Francesca Pivari ◽  
Alessandra Mingione ◽  
Caterina Brasacchio ◽  
Laura Soldati

Type 2 diabetes mellitus (T2DM) is an ensemble of metabolic diseases that has reached pandemic dimensions all over the world. The multifactorial nature of the pathology makes patient management, which includes lifelong drug therapy and lifestyle modification, extremely challenging. It is well known that T2DM is a preventable disease, therefore lowering the incidence of new T2DM cases could be a key strategy to reduce the global impact of diabetes. Currently, there is growing evidence on the efficacy of the use of medicinal plants supplements for T2DM prevention and management. Among these medicinal plants, curcumin is gaining a growing interest in the scientific community. Curcumin is a bioactive molecule present in the rhizome of the Curcuma longa plant, also known as turmeric. Curcumin has different pharmacological and biological effects that have been described by both in vitro and in vivo studies, and include antioxidant, cardio-protective, anti-inflammatory, anti-microbial, nephro-protective, anti-neoplastic, hepato-protective, immunomodulatory, hypoglycaemic and anti-rheumatic effects. In animal models, curcumin extract delays diabetes development, improves β-cell functions, prevents β-cell death, and decreases insulin resistance. The present review focuses on pre-clinical and clinical trials on curcumin supplementation in T2DM and discusses the peculiar mechanisms by which curcumin might ameliorate diabetes management.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Madhuri Patil ◽  
Uma Gunasekaran

Abstract In patients with type 2 diabetes mellitus (T2DM), dysfunction of β-cells starts years before the diagnosis of T2DM and rapidly worsens after overt hyperglycemia. Use of short-term intensive insulin therapy (STIIT) at the time of diagnosis of overt hyperglycemia has shown clinical recovery of β-cells for up to 2 years. A systematic literature review of studies looking for the effect of STIIT, used within two years of diagnosis of T2DM, on the duration from relapse of hyperglycemia to eventual insulin dependence is presented in this abstract. The key phrases ‘type 2 diabetes mellitus’, ‘short-term insulin therapy’, ‘β-cell failure’, and ‘permanent insulin dependence’ were used to search English literature. For simplicity the duration of diabetes in these studies was divided into three periods: Period 1- Diagnosis of T2DM to initiation of STIIT, Period 2- End of STIIT until relapse of hyperglycemia i.e. total glycemic remission period, and Period 3- Relapse of hyperglycemia to permanent dependence on insulin therapy. Studies were excluded if all of their participants had diagnosis of T2DM for more than 2 years at the time of inclusion, i.e., if period 1 was more than 2 years. Six clinical trials involving STIIT were identified (Period 2). No studies that examined the clinical course of T2DM in their patients beyond the relapse of hyperglycemia (Period 3) were identified. This literature review identified a lack of data about this important clinical question- do ‘recovered’ β-cells from STIIT exhibit a better response to non-insulin therapies after the end of period 2 and, hence, delay the secondary β-cell failure in period 3? There is a need to conduct studies with longer follow up to characterize the differences in the disease course between patients treated with STIIT and patients treated with non-insulin therapies. This can help us understand scope of STIIT beyond the initial functional remission of β-cells.


2016 ◽  
Vol 44 (6) ◽  
pp. 1543-1550 ◽  
Author(s):  
Bo Zhang ◽  
Yan-yan Chen ◽  
Zhao-jun Yang ◽  
Xin Wang ◽  
Guang-wei Li

Objective To investigate the role of the acute glucagon response in the long-term remission of newly diagnosed type 2 diabetes mellitus following short-term intensive insulin therapy (IIT). Methods Ten patients with newly diagnosed type 2 diabetes mellitus received IIT. Intravenous glucose tolerance tests and the clamp technique were performed pre- and post-IIT. Remission was defined as maintenance of target glycaemic control without anti-diabetic agents for 1 year. Results The remission rate was 50% (5/10). There were no differences in the acute insulin response or glucose infusion rate between groups. The acute glucagon response (AGR) in the remission group pre-IIT was significantly higher than that in the non-remission group (mean 163.02 pg/mL/min vs. mean 16.29 pg/mL/min). The mean AGR post-IIT was lower in the remission group than that in the non-remission group (0 pg/mL/min vs. 19.91 pg/mL/min). Spearman analysis indicated that the AGR pre-IIT and the change in the AGR were correlated with remission (r = 0.731). Conclusion The insulin-mediated glucose disposal rate was significantly improved with the normalization of blood glucose levels following transient IIT. Subjects with a higher AGR pre-IIT and a greater AGR decrease post-IIT displayed a greater likelihood of long-term remission.


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