scholarly journals Decrement of postprandial insulin secretion determines the progressive nature of type-2 diabetes

2006 ◽  
Vol 155 (4) ◽  
pp. 615-622 ◽  
Author(s):  
Wan Sub Shim ◽  
Soo Kyung Kim ◽  
Hae Jin Kim ◽  
Eun Seok Kang ◽  
Chul Woo Ahn ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Diabetic Patients ◽  
Β Cell ◽  
Type 2 Diabetic Patients ◽  
C Peptide ◽  
Duration Of Diabetes ◽  
Type 2 Diabetic ◽  
Postprandial Insulin

Objective: Type-2 diabetes is a progressive disease. However, little is known about whether decreased fasting or postprandial pancreatic β-cell responsiveness is more prominent with increased duration of diabetes. The aim of this study was to evaluate the relationship between insulin secretion both during fasting and 2 h postprandial, and the duration of diabetes in type-2 diabetic patients. Design: Cross-sectional clinical investigation. Methods: We conducted a meal tolerance test in 1466 type-2 diabetic patients and calculated fasting (M0) and postprandial (M1) β-cell responsiveness. Results: The fasting C-peptide, postprandial C-peptide, M0, and M1 values were lower, but HbA1c values were higher, in patients with diabetes duration > 10 years than those in other groups. There was no difference in the HbA1c levels according to the tertiles of their fasting C-peptide level. However, in a group of patients with highest postprandial C-peptide tertile, the HbA1c values were significantly lower than those in other groups. After adjustment of age, sex, and body mass index (BMI), the duration of diabetes was found to be negatively correlated with fasting C-peptide (γ = −0.102), postprandial C-peptide (γ = −0.356), M0 (γ = −0.263), and M1 (γ = −0.315; P < 0.01 respectively). After adjustment of age, sex, and BMI, HbA1c was found to be negatively correlated with postprandial C-peptide (γ = −0.264), M0 (γ = −0.379), and M1 (γ = −0.522), however, positively correlated with fasting C-peptide (γ = 0.105; P < 0.01 respectively). In stepwise multiple regression analysis, M0, M1, and homeostasis model assessment for insulin resistance (HOMA-IR) emerged as predictors of HbAlc after adjustment for age, sex, and BMI (R2 = 0.272, 0.080, and 0.056 respectively). Conclusions: With increasing duration of diabetes, the decrease of postprandial insulin secretion is becoming more prominent, and postprandial β-cell responsiveness may be a more important determinant for glycemic control than fasting β-cell responsiveness.

scholarly journals Correlation of Pulmonary Function Tests with Anthropometry and Glycaemic Control in Type 2 Diabetes Mellitus-A Cross-sectional Study

2021 ◽  
Author(s):  
Aiswarya Roy Karintholil ◽  
Akshatha Rao Aroor ◽  
Joel Sabu ◽  
Joshua Chacko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Duration Of Diabetes ◽  
Lung Functions ◽  
Type 2 Diabetic

Introduction: Diabetic patients are found to have reduced lung functions compared to their controls and their relationship with the duration of diabetes, glycaemic control, and Body Mass Index (BMI) is poorly characterised. Aim: To determine the correlation between the pulmonary function abnormalities with anthropometry, glycaemic control, and duration of diabetes in type 2 diabetic patients. Materials and Methods: A total of 80 type 2 diabetic patients were studied. BMI, Waist Circumference (WC), Waist-Hip Ratio (WHR), Fasting, postprandial blood sugar and glycosylated haemoglobin (HbA1c) were assessed from July to September 2018. Spirometry was done in accordance with the guidelines from the American Thoracic Society (ATS). Reduced pulmonary functions were defined as patients with restrictive (FEV1/FVC≥0.7 and FVC< 80% predicted) or obstructive (FEV1/FVC<0.7) impairment. Statistical analysis was done using ANOVA test and Karl Pearson Correlation coefficient. Results: The mean values of FEV1/FVC (0.8±0.08) and FVC% predicted (60.29±11.39) showed a restrictive pattern. FEF (25-75%) (r=0.241, p=0.031) and PEFR (r=0.245, p=0.029) positively correlated with duration of diabetes. BMI had a negative correlation with FVC% predicted (r=0.239, p=0.033). A negative correlation between FEV1% and Waist Circumference (WC) was observed (r=-0.232, p=0.038). HbA1c negatively correlated to FEV1/FVC (r=-0.227, p=0.043). Conclusion: Patients with type 2 Diabetes Mellitus (DM) were found to have an asymptomatic restrictive pulmonary impairment. Increased duration of diabetes, increased BMI, increased WC was associated with decreased lung functions in diabetics.

Physical training may enhance β-cell function in type 2 diabetes

2004 ◽  
Vol 287 (5) ◽  
pp. E1024-E1031 ◽  
Author(s):  
Flemming Dela ◽  
Michael E. von Linstow ◽  
Kári Joensen Mikines ◽  
Henrik Galbo
Keyword(s):  
Insulin Sensitivity ◽  
Cell Function ◽  
Diabetic Patients ◽  
Β Cell ◽  
Type 2 Diabetic Patients ◽  
C Peptide ◽  
Glucagon Test ◽  
Β Cell Function ◽  
Type 2 Diabetic

In healthy young subjects, training increases insulin sensitivity but decreases the capacity to secrete insulin. We studied whether training changes β-cell function in type 2 diabetic patients. Patients, stratified into “moderate” and “low” secretors according to individual C-peptide responses to an intravenous glucagon test, were randomly assigned to a training program [ergometer cycling 30–40 min/day, including at least 20 min at 75% maximum oxygen consumption (V̇o2 max), 5 days/wk for 3 mo] or a sedentary schedule. Before and after the intervention (16 h after last training bout), a sequential hyperglycemic (90 min at 11, 18, and 25 mM) clamp was performed. An intravenous bolus of 5 g of arginine was given at the end. Training increased V̇o2 max 17 ± 13% and decreased heart rate during submaximal exercise ( P < 0.05). During the 3 mo of sedentary lifestyle, insulin and C-peptide responses to the clamp procedures were unchanged in both moderate and low secretors. Likewise, no change in β-cell response was seen after training in the low secretors ( n = 5). In contrast, moderate secretors ( n = 9) showed significant increases in β-cell responses to 18 and 25 mM hyperglycemia and to arginine stimulation. Glucagon responses to arginine as well as measures of insulin sensitivity and Hb A1c levels were not altered by training. In conclusion, in type 2 diabetic patients, training may enhance β-cell function if the remaining secretory capacity is moderate but not if it is low. The improved β-cell function does not require changes in insulin sensitivity and Hb A1c concentration.

scholarly journals FVC, FEV1 and FEV1/FVC% in Type 2 Diabetes and Their Relationships with Duration of the Disease

1970 ◽  
Vol 4 (2) ◽  
pp. 81-87 ◽  
Author(s):  
Md Omar Ali ◽  
Shelina Begum ◽  
Noorzahan Begum ◽  
Taskina Ali ◽  
Sultana Ferdousi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Diseases ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Group A ◽  
Type 2 Diabetic

Background: Diabetes mellitus is a chronic debilitating disease affecting various organs including lungs. The magnitude of the complications of this disease is related to its duration. Objective: To observe FVC, FEV1 and FEV1/FVC% in type 2 diabetic patients and their relationship with duration of the disease. Methods: This cross-sectional study was carried out in the Department of Physiology, BSMMU, Dhaka, from July 2007 to June 2008 on 60 type 2 diabetic male patients of age 40-60 years (Group B). For comparison, 30 age and BMI matched apparently healthy non diabetic subjects (Group A) were also studied. Patients were selected from the out patient department of Bangladesh Institute of research on diabetes, endocrine and metabolic diseases. Based on duration of diabetes, diabetic patients were divided into B1 (5-10 years) and B2 (10-20 years). FVC, FEV1 and FEV1/FVC% of all the subjects were measured by a digital microspirometer. Data were analyzed by One way ANOVA test, Unpaired Student's 't' test and Pearson's correlation coefficient test as applicable. Results: Mean of the percentage of the predicted values of FVC and FEV1, were significantly (p<0.001) lower in both those of Gr. B1 and B2 than that in A and were also significantly (p<0.001) lower in Gr. B2 when compared with Gr. B1. Again, FEV1/FVC% was significantly (p<0.01) higher in Gr. B2 than those in Gr. B1 and A whereas this value was lower in Gr. B1 than those of group A but it was not statistically significant. However, FVC and FEV1 showed negative and FEV1/FVC% showed positive correlations with duration of diabetes. All these correlations were statistically non significant. Conclusion: From the result of this study it can be concluded that the ventilatory function of lung may be reduced in type 2 diabetes which may be related to the duration of the disease. Key words: FVC, FEV1, diabetes mellitus DOI: 10.3329/jbsp.v4i2.4178 J Bangladesh Soc Physiol. 2009 Dec;4(2): 81-87  

scholarly journals Small Intestinal Glucose Delivery Affects the Lowering of Blood Glucose by Acute Vildagliptin in Type 2 Diabetes

2016 ◽  
Vol 101 (12) ◽  
pp. 4769-4778 ◽  
Author(s):  
Tongzhi Wu ◽  
Xiang Zhang ◽  
Laurence G. Trahair ◽  
Michelle J. Bound ◽  
Tanya J. Little ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Emptying ◽  
Plasma Glucose ◽  
Glucose Infusion ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Glucose Lowering ◽  
C Peptide ◽  
Type 2 Diabetic

Context: The rate of gastric emptying is an important determinant of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) secretion and may influence the magnitude of glucose lowering by dipeptidyl peptidase-4 (DPP-4) inhibitors. Objective: To evaluate the effects of the DPP-4 inhibitor, vildagliptin (VILD), during intraduodenal (ID) glucose infusion at 2 different rates within the physiological range of gastric emptying, in type 2 diabetes. Participants and Design: A total of 16 diet-controlled type 2 diabetic patients were studied on 4 separate days in double-blind, randomized, fashion. On each day, either 5-mg VILD or placebo (PLBO) was given 60 minutes before a 120-minute ID glucose infusion at 2 or 4 kcal/min (ID2 or ID4). Plasma glucose and hormones were measured frequently. Results: Plasma glucose, insulin, C-peptide, glucagon, total GIP, and total and intact GLP-1 concentrations were higher during ID4 than ID2 (P &lt; .01 for each). Compared with PLBO, VILD was associated with higher intact GLP-1, insulin, and C-peptide and lower glucose and total GIP and GLP-1 (P &lt; .01 for each), without affecting glucagon. There were significant interactions between the rate of ID glucose and VILD treatment on plasma glucose, intact and total GLP-1, and GIP (P &lt; .05 for each) but not insulin, C-peptide, or glucagon. The reduction in glucose and the increment in intact GLP-1 after VILD vs PLBO were 3.3- and 3.8-fold greater, respectively, during ID4 compared with ID2. Conclusions/Interpretation: These observations warrant further study to clarify whether type 2 diabetic patients with relatively more rapid gastric emptying have greater glucose lowering during treatment with DPP-4 inhibitors.

scholarly journals Trace elements status in type 2 diabetes

1970 ◽  
Vol 8 (3) ◽  
pp. 52-56 ◽  
Author(s):  
Fatma Hussain ◽  
Mohammad Arif Maan ◽  
Munir Ahmed Sheikh ◽  
Haq Nawaz ◽  
Amer Jamil
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Trace Elements ◽  
Serum Levels ◽  
Diabetic Patients ◽  
Glycemic Status ◽  
Type 2 Diabetic Patients ◽  
Duration Of Diabetes ◽  
Type 2 Diabetic

Background: The metabolism of several trace elements has been reported to alter in diabetes mellitus and these elements might have specific roles in the pathogenesis and progress of this disease. Objective: The aim of the present study was to investigate serum levels of copper, zinc, chromium, magnesium and manganese in type 2 diabetic patients and their possible association with age, glycemic status and duration of diabetes. Methodology: The comparative study included 116 type 2 diabetic patients and 40 non-diabetic subjects. Fasting plasma glucose and HbA1c were determined by the glucose oxidase method and affinity chromatography respectively. The element concentrations were measured by means of an atomic absorption spectrophotometer after microwave-induced acid digestion. Results: Mean (±SD) Mg and Zn levels were significantly reduced in blood samples of diabetic patients as compared to control subjects (p<0.0001-<0.05). The alterations observed in serum levels of copper and manganese was not significant among diabetic and normal subjects. Glycemic status, duration of diabetes and age did not effect the trace elements concentrations. Conclusion: The results confirm that deficiency and efficiency of some essential trace metals may play a role in the development of diabetes mellitus. Key words: Trace elements, glycemic status, type 2 diabetes. DOI: 10.3329/bjms.v8i3.3983 Bangladesh Journal of Medical Sciences Vol.8(3) 2009 p52-56

Predictive Value of Osteoprotegerin for Detecting Coronary Artery Calcification in Type 2 Diabetes Mellitus Patients in Correlation with Extent of Calcification Detected by Multidetector Computed Tomography

2019 ◽  
Vol 19 (6) ◽  
pp. 845-851 ◽  
Author(s):  
Sahar Ahmed ◽  
Rasha Sobh
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diabetic Patients ◽  
Coronary Artery Calcification Score ◽  
Type 2 Diabetic Patients ◽  
Duration Of Diabetes ◽  
Calcification Score ◽  
Type 2 Diabetic

Background:Osteoprotegerin (OPG) is a tumor necrosis factor receptor super-family member. It specifically acts on bone by increasing bone mineral density and bone volume. Recent studies have evidenced its close relation to the development of atherosclerosis and plaque destabilization. Elevated OPG level has also been associated with the degree of coronary calcification in the general population and it has been considered to be a marker of coronary atherosclerosis.Objective:The aim of this study was to determine the relation between OPG levels and Coronary Artery Calcification score (CACs) in Type 2 diabetic patients in comparison to healthy controls.Methods:Our study included 45 type 2 diabetic patients (mean age 51.7 years; 51.1% male) without evidence of previous CVD and 45 healthy age and sex matched subjects as control. All participants were subjected to full history, full examination and lab investigations. Serum OPG concentration was measured by an enzyme-linked immunosorbent assay (ELISA) and CAC imaging was performed using non contrast Multi detector CT of the heart.Results:Significant CAC (<10 Agatston units) was seen in 23 patients (51.11 %).:OPG was significantly high in diabetic patients in comparison to controls with mean 12.9±5.7 pmol/l in cases, and 8.6±0.5 pmol/l in controls (P value < 0.001).:The Coronary Artery Calcification Score (CACS) was positively correlated with age and duration of diabetes. The OPG was positively correlated with age, fasting blood sugar and duration of diabetes. The CACS showed a significantly positive correlation with OPG.Conclusion:Findings suggested that increasing in serum OPG was consistent with CAC and could be used for the early diagnosis of subclinical atherosclerosis.

scholarly journals Body Mass Index, Fasting Plasma Glucose Levels, and C-peptide Levels as Predictors of the Future Insulin Use in Japanese Type 2 Diabetic Patients

2010 ◽  
Vol 57 (3) ◽  
pp. 237-244 ◽  
Author(s):  
Atsushi GOTO ◽  
Maki TAKAICHI ◽  
Miyako KISHIMOTO ◽  
Yoshihiko TAKAHASHI ◽  
Hiroshi KAJIO ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
C Peptide ◽  
Glucose Levels ◽  
Insulin Use ◽  
Type 2 Diabetic

Effects on insulin secretion and insulin action of a 48-h reduction of plasma free fatty acids with acipimox in nondiabetic subjects genetically predisposed to type 2 diabetes

2007 ◽  
Vol 292 (6) ◽  
pp. E1775-E1781 ◽  
Author(s):  
Kenneth Cusi ◽  
Sangeeta Kashyap ◽  
Amalia Gastaldelli ◽  
Mandeep Bajaj ◽  
Eugenio Cersosimo
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Family History ◽  
Second Phase ◽  
Β Cell ◽  
C Peptide ◽  
Hyperglycemic Clamp ◽  
History Of ◽  
Plasma Ffa

Elevated plasma FFA cause β-cell lipotoxicity and impair insulin secretion in nondiabetic subjects predisposed to type 2 diabetes mellitus [T2DM; i.e., with a strong family history of T2DM (FH+)] but not in nondiabetic subjects without a family history of T2DM. To determine whether lowering plasma FFA with acipimox, an antilipolytic nicotinic acid derivative, may enhance insulin secretion, nine FH+ volunteers were admitted twice and received in random order either acipimox or placebo (double-blind) for 48 h. Plasma glucose/insulin/C-peptide concentrations were measured from 0800 to 2400. On day 3, insulin secretion rates (ISRs) were assessed during a +125 mg/dl hyperglycemic clamp. Acipimox reduced 48-h plasma FFA by 36% ( P < 0.001) and increased the plasma C-peptide relative to the plasma glucose concentration or ΔC-peptide/Δglucose AUC (+177%, P = 0.02), an index of improved β-cell function. Acipimox improved insulin sensitivity (M/I) 26.1 ± 5% ( P < 0.04). First- (+19 ± 6%, P = 0.1) and second-phase (+31 ± 6%, P = 0.05) ISRs during the hyperglycemic clamp also improved. This was particularly evident when examined relative to the prevailing insulin resistance [1/(M/I)], as both first- and second-phase ISR markedly increased by 29 ± 7 ( P < 0.05) and 41 ± 8% ( P = 0.02). There was an inverse correlation between fasting FFA and first-phase ISR ( r2 = 0.31, P < 0.02) and acute (2–4 min) glucose-induced insulin release after acipimox ( r2 =0.52, P < 0.04). In this proof-of-concept study in FH+ individuals predisposed to T2DM, a 48-h reduction of plasma FFA improves day-long meal and glucose-stimulated insulin secretion. These results provide additional evidence for the important role that plasma FFA play regarding insulin secretion in FH+ subjects predisposed to T2DM.

scholarly journals Impact of a Booklet about Diabetes Genetic Susceptibility and Its Prevention on Attitudes towards Prevention and Perceived Behavioral Change in Patients with Type 2 Diabetes and Their Offspring

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Masakazu Nishigaki ◽  
Eiko Sato ◽  
Ryota Ochiai ◽  
Taiga Shibayama ◽  
Keiko Kazuma
Keyword(s):  
Type 2 Diabetes ◽  
Genetic Susceptibility ◽  
Behavioral Change ◽  
Behavioral Changes ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
The Patient’S View ◽  
Self Administered Questionnaire ◽  
Type 2 Diabetic

Background. Offspring of type 2 diabetic patients are at a high risk of type 2 diabetes. Information on diabetes genetic susceptibility and prevention should be supplied to the offspring.Methods. A six-page booklet on diabetes genetic susceptibility and prevention was distributed to 173 patients who ere ordered to hand it to their offspring. The patients answered a self-administered questionnaire on booklet delivery and attitudinal and behavioral changes toward diabetes and its prevention in themselves and their offspring.Results. Valid responses were obtained from 130 patients. Forty-nine patients had actually handed the booklet. Booklet induces more relief than anxiety. From the patient's view, favorable attitudinal and/or behavioral changes occurred in more than half of the offspring who were delivered the booklet.Conclusion. The booklet worked effectively on attitudes and behaviors toward diabetes and its prevention both in patients and their offspring. However, the effectiveness of patients as information deliverers was limited.

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