Enhancement of B-cell secretion by blood glucose normalization in type 2 diabetes is associated with fasting C-peptide levels.
OBJECTIVE
To investigate (i) the variability of beneficial effects achieved by short-term near-normalization of blood glucose in type 2 diabetes patients, and (ii) the relationship of beneficial effects to individual characteristics of diabetes.


METHODS
Arginine-induced insulin and glucagon release tested at two glucose levels before and after 3 days of intensive insulin treatment.


METHODS
The Department of Endocrinology and Diabetology, Karolinska Hospital, Stockholm, Sweden.


METHODS
Type 2 diabetes patients with poor metabolic control sampled from an area-based population of diabetes patients.


RESULTS
Levels of fasting blood glucose declined from 15.0 +/- 0.9 to 8.5 +/- 0.7 mmol L-1, C-peptide from 0.81 +/- 0.06 to 0.49 +/- 0.05 nmol L-1 and percent proinsulin (of total IRI) from 7.8 +/- 1.0 to 3.2 +/- 0.6%. At comparable glucose levels arginine-induced insulin secretion was enhanced 46.3 +/- 19.5% (range -36 to 220%). Enhancement correlated with extent of blood glucose normalization and also with fasting C-peptide levels and with overweight. Arginine-induced glucagon secretion was nonsignificantly depressed (17.2 +/- 7.4%, range -59 to 29%). Insulin sensitivity assessed by M:I ratio was increased by a median of 95%.


CONCLUSIONS
In type 2 diabetes patients reversibility of the effects of poor metabolic control on B-cell function is variable. Variability is related to B-cell mass in individual patients with type 2 diabetes.
Clauson
P
P
Department of Diabetology and Endocrinology, Karolinska Hospital, Stockholm, Sweden.
Alvarsson
M
M
Grill
V
V
D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism*; D005215:Fasting; D005260:Female; D005934:Glucagon / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood*; D007515:Islets of Langerhans / Q000378:metabolism*; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D005934:Glucagon