Study of phases of insulin secretion in pre-diabetes and newly diagnosed type 2 diabetes mellitus

Background: Insulin is released from the pancreas in a biphasic manner in response to arterial glucose concentration. The assumption has been generally made that the 30-minute response reflected first-phase insulin release, whereas the 120-minute response reflected second-phase insulin release.Objectives: The aim of this study was to identify the defect in first and second phases of insulin secretion in pre-diabetes and newly diagnosed T2DM.Methods: This case-control study was conducted in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka from March 2013 to June 2014. All the study subjects (n = 94) were collected from the one point centre, BSMMU as newly diagnosed T2DM, pre-diabetes and healthy normal glucose tolerant subjects according to fasting plasma glucose and 2 hour plasma glucose status. A total of 32 newly diagnosed T2DM and 32 pre-diabetes were included on the basis of inclusion criteria as cases. Another 30 healthy normal glucose tolerant subjects were emolled as control. Fasting blood samples were collected from study subjects to estimate the plasma glucose and insulin level. Again blood samples were taken for measurement of plasma glucose and insulin level at 30 minute and 120 minute on OGTT.Results: Fasting plasma insulin was significantly higher in pre-diabetes than control and T2DM (p = 0.011). Plasma insulin at 30 minute and 120 minute of OGTT were significantly lower in T2DM than control and pre- diabetes (p = 0.001 & 0.016). The insulin secretion in first and second phases were significantly lower in T2DM patients than controls and pre-diabetes (p = 0.000). Beta-cell function was also significantly lower in T2DM than controls and pre-diabetes (p = 0.000). Median values of HOMA-IR were higher in pre-diabetes (1.68) and T2DM (1.53) than control (1.37), but not statistically significant (p = 0.153). There was significant positive correlation of both phases of insulin secretion with FPI, beta-cell function and insulin resistance in T2DM, pre-diabetes and controls.Conclusions: The study reveals that 1st and 2nd phase insulin secretory defect was detected in T2DM, but in pre-diabetes, we have failed to identify insulin secretory defects in both phases.

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β-Cell Function and Insulin Sensitivity in Normal Glucose-Tolerant Subjects Stratified by 1-Hour Plasma Glucose Values

Diabetes Technology & Therapeutics ◽

10.1089/dia.2015.0065 ◽

2016 ◽

Vol 18 (1) ◽

pp. 29-33 ◽

Cited By ~ 10

Author(s):

Miranda M. Priya ◽

Anandakumar Amutha ◽

T.A. Pramodkumar ◽

Harish Ranjani ◽

Saravanan Jebarani ◽

...

Keyword(s):

Insulin Sensitivity ◽

Plasma Glucose ◽

Cell Function ◽

Β Cell ◽

Normal Glucose Tolerant ◽

Normal Glucose ◽

Glucose Tolerant ◽

Β Cell Function

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Mild Physiologic Hyperglycemia Impairs Beta-Cell Function and Induces Insulin Resistance in Healthy Normal Glucose Tolerant Subjects

Diabetes ◽

10.2337/db18-1827-p ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 1827-P

Author(s):

AURORA MEROVCI ◽

ENRIQUE R. MALDONADO CORCHADO ◽

DEVJIT TRIPATHY ◽

RALPH A. DEFRONZO

Keyword(s):

Insulin Resistance ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Normal Glucose Tolerant ◽

Normal Glucose ◽

Glucose Tolerant

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Endogenous glucose production, insulin sensitivity, and insulin secretion in normal glucose-tolerant Pima Indians with low birth weight

Metabolism ◽

10.1016/j.metabol.2004.01.014 ◽

2004 ◽

Vol 53 (7) ◽

pp. 904-911 ◽

Cited By ~ 15

Author(s):

Norbert Stefan ◽

Christian Weyer ◽

Claire Levy-Marchal ◽

Michael Stumvoll ◽

William C Knowler ◽

...

Keyword(s):

Insulin Secretion ◽

Birth Weight ◽

Insulin Sensitivity ◽

Glucose Production ◽

Endogenous Glucose Production ◽

Pima Indians ◽

Normal Glucose Tolerant ◽

Normal Glucose ◽

Glucose Tolerant ◽

Endogenous Glucose

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The Gly972Arg Polymorphism in the Insulin Receptor Substrate-1 Gene Contributes to the Variation in insulin Secretion in Normal Glucose-Tolerant Humans

Diabetes ◽

10.2337/diabetes.50.4.882 ◽

2001 ◽

Vol 50 (4) ◽

pp. 882-885 ◽

Cited By ~ 52

Author(s):

M. Stumvoll ◽

A. Fritsche ◽

A. Volk ◽

N. Stefan ◽

A. Madaus ◽

...

Keyword(s):

Insulin Secretion ◽

Insulin Receptor ◽

Insulin Receptor Substrate ◽

Insulin Receptor Substrate 1 ◽

Normal Glucose Tolerant ◽

Normal Glucose ◽

Glucose Tolerant

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Relation of C-reactive protein to features of the metabolic syndrome in normal glucose tolerant, impaired glucose tolerant, and newly diagnosed type 2 diabetic subjects

Diabetes & Metabolism ◽

10.1016/s1262-3636(07)70009-5 ◽

2003 ◽

Vol 29 (1) ◽

pp. 65-71 ◽

Cited By ~ 27

Author(s):

F Guerrero-Romero ◽

M Rodríguez-Morán

Keyword(s):

Metabolic Syndrome ◽

Newly Diagnosed ◽

C Reactive Protein ◽

Reactive Protein ◽

The Metabolic Syndrome ◽

Normal Glucose Tolerant ◽

Normal Glucose ◽

Glucose Tolerant ◽

Type 2 Diabetic

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Decreased Insulin Secretion but Not Insulin Sensitivity in Normal Glucose Tolerant Thai Subjects

Diabetes Care ◽

10.2337/diacare.29.03.06.dc05-2250 ◽

2006 ◽

Vol 29 (3) ◽

pp. 742-743 ◽

Cited By ~ 11

Author(s):

C. Rattarasarn ◽

S. Soonthornpan ◽

R. Leelawattana ◽

W. Setasuban

Keyword(s):

Insulin Secretion ◽

Insulin Sensitivity ◽

Thai Subjects ◽

Normal Glucose Tolerant ◽

Normal Glucose ◽

Glucose Tolerant

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Decline in Beta-Cell Function among Adolescents with Type 2 Diabetes Mellitus

JMS SKIMS ◽

10.33883/jms.v20i2.211 ◽

2017 ◽

Vol 20 (2) ◽

pp. 115-116

Author(s):

Shariq Rashid Masoodi

Keyword(s):

Diabetes Mellitus ◽

Insulin Secretion ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Fasting Glucose ◽

Newly Diagnosed ◽

Annual Decline ◽

Over Time

It is well known that beta-cell function declines over time in adults with type 2 diabetes mellitus (T2DM). The beta-cell dysfunction, initially characterized by impairment in the first phase of insulin secretion following glucose stimulation, advances to a decline in second phase insulin secretion as the disease progresses. But whether this decline in beta-cell function occurs in adolescents with T2DM is uncertain. Investigators prospectively compared beta-cell functioning over time between 39 adolescents with newly diagnosed T2DM (mean age, 15 years; body-mass index z-score, 2.4) and 32 obese adolescents without T2DM of comparable body-mass index, gender, and race (mean age, 14) during a 2-year period. Recently, researchers from Duke University School of Medicine, Durham North Carolina reported that adolescents with newly diagnosed T2DM had a 25% annual decline in beta-cell function despite receiving treatment. In this study, the results of which were first presented at the American Diabetes Association (ADA), the participants were adolescents with T2DM, more than half of whom were being treated with insulin whereas 80% were taking oral anti-diabetes medications. Beta-cell function in this study, assessed at baseline and 6, 12, and 24 months was measured by insulin secretion in response to an intravenous glucose load adjusted for insulin sensitivity (disposition index). The authors observed that adolescents with T2DM had significantly higher levels of both insulin resistance and fasting glucose at baseline compared with controls. But during the two-year study, the study subjects experienced a significant increase in fasting glucose and a 25 percent annual decline in disposition index. Understandably, both these indicators remained unchanged among the controls. JMS 2017;20(2):116

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