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Item
#15
Postprandial Insulin
Deficiency Major Factor Of Deteriorating Glucose Control
Postprandial
insulin deficiency is the most powerful explanatory factor of
deteriorating glucose control in newly presenting type 2 diabetes.
"Indices of insulin sensitivity and pancreatic beta-cell
responsiveness explain fasting glucose and HbA1c (glycated
hemoglobin) well but fail to explain postprandial glucose," add
investigators from City University in London and the University of
Wales College of Medicine, United Kingdom.
The investigators examined the ability of indices of insulin
sensitivity and pancreatic beta-cell responsiveness to explain
interindividual variability of glucose control measures in 65
patients with newly presenting type 2 diabetes.
Minimal model-derived insulin sensitivity, glucose effectiveness,
first-phase insulin secretion and disposition index were
determined using an insulin-modified iv glucose tolerance test.
Fasting/basal and postprandial pancreatic beta-cell responsiveness
was measured by a standard meal tolerance test.
Stepwise linear regression was used with these indices to explain
the interindividual variability of fasting and postprandial
concentrations of plasma glucose, plasma insulin and HbA1c.
Results showed a negative correlation between measures of
pancreatic beta-cell responsiveness and fasting plasma glucose.
Pancreatic beta-cell responsive measures were positively
correlated with fasting plasma insulin and insulin response to the
meal tolerance test.
Minimal model-derived insulin sensitivity was found to be
negatively correlated with fasting plasma insulin but was not
correlated with any glucose variable.
Postprandial beta-cell responsiveness and disposition index were
the "most informative in explaining interindividual variability,"
according to the investigators.
J Clin Endocrinol Metab 2002; 87(1):
198-203
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Fact:
For every one-percentage point drop in the
Hemoglobin A1c diabetes complication rates drop by more than 25%.
Source:
Diabetes 2001: Vital Stats.
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