Diet Treatment of Newly Presenting Type 2 Diabetes Improves Insulin Secretory Capacity, but Has No Effect on Insulin Sensitivity

Background: Diabetes mellitus coexists at a greater frequency with hypertension, obesity, central obesity, and dyslipidemia. Obesity has been identified as the most important modifiable risk factor in the aetiology of type-2 diabetes mellitus. Central obesity has been shown to be the most pathogenically important in the causation of metabolic disorders including type-2 diabetes. Aims: To determine the association of central obesity with type 2 diabetes in Bangladeshi women. Subjects and Methods: A total of 60 type 2 diabetic female subjects along with 60 healthy female subjects were recruited in this study. Anthropometric indices were measured using standard techniques. Serum glucose was measured using glucose-oxidase method, insulin was measured using ELISA and thyroid hormones were measured using chemiluminescence based automated Immulite Auto analyzer (DPC, USA). Insulin secretory capacity and insulin sensitivity were estimated using fasting glucose and fasting insulin by HOMA-CIGMA software. Results: Waist circumference of the control (89±8) subjects was significantly (p=0.046) lower than the diabetic (94±11) subjects. Waist-hip ratio of the control subjects was significantly lower compared to diabetic subjects. Fasting plasma insulin level in control subjects (7.6±2.2) was significantly (p=0.009) lower compared to diabetic subjects (11.8±9.8). Plasma lipid profile and thyroid hormone status in control and diabetic subjects were not found significantly different. Insulin secretory capacity (HOMA %B) and insulin sensitivity (HOMA%S) in control subjects (93±21, 95±39 respectively) were found to be significantly higher com-pared to diabetic subjects (45±32, 67±42 respectively). In age-adjusted binary logistic regression analysis, waist circumference was found to be significantly associated with diabetes. In multiple linear regression analysis TSH was found to be significantly associated with waist circumference. Conclusion: Waist circumference may be an independent indicator for the development type 2 diabetes in Bangladeshi women which may have influenced by thyroid stimulating hormone (TSH). DOI: http://dx.doi.org/10.3329/bjms.v13i3.19149 Bangladesh Journal of Medical Science Vol.13(3) 2014 p.278-284

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Association between Pancreatic Atrophy and Loss of Insulin Secretory Capacity in Patients with Type 2 Diabetes Mellitus

Journal of Diabetes Research ◽

10.1155/2019/6371231 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Jun Lu ◽

Meixiang Guo ◽

Hongtao Wang ◽

Haibin Pan ◽

Liang Wang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Multiple Logistic Regression Analysis ◽

Insulin Deficiency ◽

Cross Sectional ◽

Pancreatic Atrophy ◽

Insulin Secretory Capacity ◽

Absolute Insulin Deficiency ◽

Secretory Capacity

Aims. To examine pancreatic volume (PV) changes among patients with different duration of type 2 diabetes and whether pancreatic atrophy was associated with loss of insulin secretory capacity. Methods. This cross-sectional study (203 patients with type 2 diabetes, 93 controls without diabetes) was conducted from January 2016 to December 2017. Patients with type 2 diabetes were divided into 3 groups: recently diagnosed (duration≤2 years), midterm (duration 3-9 years), and long term (duration≥10 years). All the patients were scanned with upper abdominal computerized tomography; PV was then calculated by an experienced technician. Absolute insulin deficiency was defined as fasting C−peptide<0.9 ng/mL. Results. Compared with PV (cm3) in the controls, the mean PV was similar in patients with recently diagnosed type 2 diabetes (68.8 versus 71.0, P=0.56) but significantly reduced in patients with midterm (68.8 versus 60.8, P<0.05) and long-term (68.8 versus 53.1, P<0.001) type 2 diabetes. A similar trend was observed for the PV index (PV adjusted for body surface area and body mass index). Furthermore, rates of pancreatic atrophy and absolute insulin deficiency increased with duration of diabetes. Multiple logistic regression analysis indicated that pancreatic atrophy was associated with higher likelihood of absolute insulin deficiency (odds ratio=4.47, 95%confidence interval=1.45‐13.8). Conclusions. PV was reduced in those with midterm and long-term type 2 diabetes compared to individuals without type 2 diabetes. Overall, pancreatic atrophy was associated with the loss of insulin secretory capacity in patients with type 2 diabetes.

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Impaired β-cell sensitivity to glucose and maximal insulin secretory capacity in adolescents with type 2 diabetes

Pediatric Diabetes ◽

10.1111/j.1399-5448.2009.00601.x ◽

2009 ◽

Vol 11 (5) ◽

pp. 314-321 ◽

Cited By ~ 9

Author(s):

Deborah A Elder ◽

Jessica G Woo ◽

David A D'Alessio

Keyword(s):

Type 2 Diabetes ◽

Β Cell ◽

Cell Sensitivity ◽

Insulin Secretory Capacity ◽

Secretory Capacity

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Leptin and Other Factors as Determinants of Insulin Secretion and Sensitivity in Bangladeshi Type 2 Diabetic Subjects

Journal of Bangladesh Society of Physiologist ◽

10.3329/jbsp.v3i0.1786 ◽

1970 ◽

Vol 3 ◽

pp. 1-7

Author(s):

Manindra Nath Roy ◽

Salima Akter ◽

Mohammad Jafarulla ◽

Forhadul Hoque Mollah ◽

Ajanta Rani Saha ◽

...

Keyword(s):

Insulin Resistance ◽

Insulin Secretion ◽

Insulin Sensitivity ◽

B Cell ◽

Plasma Glucose ◽

Key Words Leptin ◽

Type 2 Diabetic ◽

Insulin Secretory Capacity ◽

Secretory Capacity

Background: The relative contribution of insulin secretion and sensitivity in the development of Type 2 diabetes mellitus (T2DM) vary from population to population due to the heterogeneous nature of the disease. The study was undertaken to evaluate insulin secretory capacity and sensitivity in a Bangladeshi Type 2 diabetic population and to explore the association of some of the anthropometric and biochemical factors known to modulate B-cell function and insulin action. Methods: Ninety one T2DM subjects and 32 age-matched controls were studied for their fasting plasma glucose (FPG), lipids, HbA1c (by HPLC), leptin and C-peptide (ELISA). Insulin secretion (HOMA B) and insulin sensitivity (HOMA S) were calculated by homeostasis model assessment (HOMA). Results: Both insulin secretion and sensitivity were significantly reduced in diabetic as compared to control (HOMA B%, geometric meanÂ±SD, 35.65Â±1.75 vs. 96.29Â±1.50, p < 0.001; HOMA S%, 68.66Â±1.71 vs. 104.951.63, p < 0.001). However, B-cell dysfunction was predominant than insulin resistance in predicting T2DM as the discriminate function coefficient for HOMA B (1.098) was greater than that for HOMA S (0.821). In T2DM, HOMA B had positive correlation with BMI (r=0.368, p < 0.001) and HOMA S was inversely correlated to BMI (r=-0.261, p < 0.01), WHR (r=-0.258, p < 0.01) and plasma TG (r=-0.233, p < 0.001). On multiple regression analysis HOMA B and HOMA S were found to be inversely associated to FPG (p < 0.001) and leptin (p < 0.05) in T2DM. Conclusions: Both insulin secretory dysfunction and insulin resistance are present in Bangladeshi T2DM subjects, but B-cell failure seems to be the predominant abnormality. BMI, plasma glucose, insulin and leptin are the major determinants of insulin secretory capacity and generalized as well as central obesity, plasma glucose, triglycerides, insulin and leptin are among the major determinants of insulin sensitivity in this population. Key Words: Leptin, Insulin, Diabetes Â doi: 10.3329/jbsp.v3i0.1786 J Bangladesh Soc Physiol. 2008 Dec;(3):1-7.

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