Year: 2013
Type: article
Abstract: Objectives: The primary aim of this study was to assess residual beta cell function at diagnosis of type 2 diabetes and identify accessible laboratory markers that best estimate it.The secondary objective was to evaluate the change in beta cell function 6 months after starting different therapeutical regimens.Materials and methods: Forty seven subjects were included in the study and each performed a 75-g oral glucose tolerance test (OGTT) at baseline and after 6 months.Metabolic and immunologic parameters were determined from fasting samples.According to the degree of metabolic decompensation, specific therapy was started: metformin, metformin plus gliclazide or insulin therapy (with/out metformin).Early and total beta cell function was evaluated by the disposition index (DI) calculated for 30 minutes and 120 minutes, respectively.Results: At diagnosis, fasting blood glucose (BG) and HbA1c varied largely (129-521 mg/dl and 5.5-14%, respectively).The DI30 and DI120 decreased with more severe glycemic decompensation.For both DI30 and DI120 significant negative correlations were found for glycemic markers (HbA1c, and positive correlation for 2hour C peptide (p<0.0001for all).HbA1c value of 7% discriminated an important decrease of DI30 and DI120.Insulin and combined therapy significantly improved DI120 at 6 months (p: 0.0062 and 0.01, respectively), while DI30 was improved only with insulin therapy (p: 0.0326).Conclusions: Beta cell function at onset correlated with HbA1c, 2-hour BG and C peptide during OGTT.Thus OGTT and HbA1c are pivotal for evaluation of beta cell function.Insulin therapy improved early and total insulin secretion at 6 months.
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2061634391