Year: 2013
Type: article
Abstract: We examined the metabolic characteristics that attend the development of type 2 diabetes (T2DM) in 441 impaired glucose tolerance (IGT) subjects who participated in the ACT NOW Study and had complete end-of-study metabolic measurements. Subjects were randomized to receive pioglitazone (PGZ; 45 mg/day) or placebo and were observed for a median of 2.4 years. Indices of insulin sensitivity (Matsuda index [MI]), insulin secretion (IS)/insulin resistance (IR; ΔI0-120/ΔG0-120, ΔIS rate [ISR]0-120/ΔG0-120), and β-cell function (ΔI/ΔG × MI and ΔISR/ΔG × MI) were calculated from plasma glucose, insulin, and C-peptide concentrations during oral glucose tolerance tests at baseline and study end. Diabetes developed in 45 placebo-treated vs. 15 PGZ-treated subjects (odds ratio [OR] 0.28 [95% CI 0.15-0.49]; P < 0.0001); 48% of PGZ-treated subjects reverted to normal glucose tolerance (NGT) versus 28% of placebo-treated subjects (P < 0.005). Higher final glucose tolerance status (NGT > IGT > T2DM) was associated with improvements in insulin sensitivity (OR 0.61 [95% CI 0.54-0.80]), IS (OR 0.61 [95% CI 0.50-0.75]), and β-cell function (ln IS/IR index and ln ISR/IR index) (OR 0.26 [95% CI 0.19-0.37]; all P < 0.0001). Of the factors measured, improved β-cell function was most closely associated with final glucose tolerance status.
Source: Diabetes
DOI: 10.2337/db13-0265
Institutions: The University of Texas at San Antonio Health Science Center, Texas Diabetes Institute, Phoenix VA Health Care System, Arizona State University, SUNY Downstate Health Sciences University, Pennington Biomedical Research Center, Louisiana State University, University of Southern California, Georgetown University, Istituto di Fisiologia Clinica, University of California San Diego, VA San Diego Healthcare System, University of Tennessee Health Science Center, MedStar Health Research Institute
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Amgen, Bristol-Myers Squibb, Eli Lilly and Company, AstraZeneca, Sanofi, Gilead Sciences, University of Southern California, Intarcia Therapeutics, Novo Nordisk, National Institutes of Health, Health Science Center, University of Tennessee, Allergan, National Center for Research Resources, National Center for Advancing Translational Sciences, Daiichi Sankyo Europe
OpenAlex ID: W2103930636