title: Effect of Glycemic Control on Chylomicron Metabolism and Correlation between Postprandial Metabolism of Plasma Glucose and Chylomicron in Patients with Type 2 Diabetes Treated with Basal-bolus Insulin Therapy with or without Vildagliptin.
abstract: OBJECTIVE
  Glucagon-like peptide-1 can reduce both postprandial plasma glucose (PG) and chylomicron (CM) levels in patients with type 2 diabetes. However, there have been no reports regarding the relationship between the postprandial metabolism of PG and CM.
  
  
  METHODS
  Patients with type 2 diabetes who were admitted for glycemic control were randomized to insulin alone (Ins; n=16) or insulin plus vildagliptin 100 mg (InsV; n=16) groups. The insulin dose was adjusted to maintain normal blood glucose levels. The daily profiles of serum TG, remnant lipoprotein cholesterol (RemL-C), and apolipoprotein B48 (ApoB48) were estimated by frequent blood collection on admission and before discharge, and the daily glucose fluctuation profile was also estimated using continuous glucose monitoring (CGM) before discharge.
  
  
  RESULTS
  The daily profiles of serum TG and RemL-C indicated a significant decrease before discharge compared with on admission; however, no significant changes in serum ApoB48 levels were observed in either group. At discharge, daily glucose fluctuation profile and the change in the serum ApoB48 level from fasting to the peak of the daily profile was significantly smaller in the InsV group than in the Ins group. The increment of serum ApoB48 level was significantly correlated with the mean amplitude of glycemic excursions calculated using CGM data only in the Ins group (R2= 0.5242,P＜0.001).
  
  
  CONCLUSIONS
  Short-term glycemic control decreased serum TG and RemL-C levels, but not ApoB48 levels, and the postprandial metabolism of PG and CM might be regulated by the same mechanism except GLP-1 effect.
authors.affiliation: Division of Endocrinology, Department of Medicine, Chiba-Hokusoh Hospital, Nippon Medical School.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Okajima
authors.forename: Naoya
authors.initials: N
authors.lastname: Emoto
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Kato
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sugihara
mesh_terms: D000218:Adamantane / Q000031:analogs & derivatives* / Q000494:pharmacology; D000328:Adult; D000368:Aged; D053283:Apolipoprotein B-48 / Q000378:metabolism; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism*; D002784:Cholesterol / Q000378:metabolism; D002914:Chylomicrons / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000378:metabolism*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000494:pharmacology; D004359:Drug Therapy, Combination; D005215:Fasting; D005260:Female; D005500:Follow-Up Studies; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology; D007328:Insulin / Q000494:pharmacology*; D008074:Lipoproteins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000494:pharmacology*; D019518:Postprandial Period; D011379:Prognosis; D011759:Pyrrolidines / Q000494:pharmacology*; D014280:Triglycerides / Q000378:metabolism; D000077597:Vildagliptin; D055815:Young Adult
chemical_list: D053283:Apolipoprotein B-48; D015415:Biomarkers; D001786:Blood Glucose; D002914:Chylomicrons; D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D008074:Lipoproteins; D009570:Nitriles; D011759:Pyrrolidines; D014280:Triglycerides; C030104:lipoprotein cholesterol; D002784:Cholesterol; D000077597:Vildagliptin; D000218:Adamantane