title: The capability of glucose toxicity on severe type 2 diabetes.
abstract: The underlying defects of type 2 diabetes are impaired insulin sensitivity and decreased beta-cell function. In poorly controlled type 2 diabetes, the 'glucose toxicity' further deteriorates these defects. The objective was to determine whether correction of glucose toxicity will lead to improve insulin sensitivity and beta-cell function in these severely affected patients. Twelve severe type 2 diabetic patients were enrolled. An intravenous glucose tolerance test was performed before and after treatment with insulin for 3 months. The insulin sensitivity, glucose sensitivity, and acute insulin response after glucose loading were calculated by a minimal model algorithm. The lipid profiles did not change significantly after insulin therapy, but the hemoglobin A1c, level improved significantly (12.2 +/- 2.2% to 9.2 +/- 1.9%; p = 0.001). The insulin sensitivity, glucose sensitivity, and acute insulin response did not change significantly with insulin therapy. Correction of hyperglycemia with 3-month insulin therapy may improve metabolic effect instead of insulin sensitivity, glucose sensitivity, and acute insulin response to glucose load in severe type 2 diabetic patients.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Chang-Hsun
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Hung
authors.forename: Chih-Tseung
authors.initials: CT
authors.lastname: He
authors.forename: Chien-Hsing
authors.initials: CH
authors.lastname: Lee
authors.forename: Szu-Chun
authors.initials: SC
authors.lastname: Hung
authors.forename: Yi-Kuan
authors.initials: YK
authors.lastname: Wang
authors.forename: Shi-Wen
authors.initials: SW
authors.lastname: Kuo
authors.forename: Dee
authors.initials: D
authors.lastname: Pei
mesh_terms: D000368:Aged; D000465:Algorithms; D001786:Blood Glucose / Q000032:analysis / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D007328:Insulin / Q000494:pharmacology / Q000627:therapeutic use; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000187:drug effects / Q000378:metabolism / Q000502:physiology; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin