Premium
Insulin sensitivity and pancreatic function in type 2 diabetics with and without insulin treatment
Author(s) -
Gavin Timothy P,
Ernst Jacob M,
Kehe Sarah E,
Dohm G Lynis,
Pories Walter J,
Dar Moahad,
Reed Melissa A
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.1202.10
Subject(s) - glycemic , medicine , insulin , endocrinology , type 2 diabetes , diabetes mellitus , insulin resistance , glucose tolerance test , pancreatic hormone
As type 2 diabetes (T2D) progresses, often the addition of insulin is required along with oral glycemic medications for glycemic control. We questioned if pancreatic function, insulin sensitivity, or both were lower in T2D using insulin (INS: N=9) vs. oral glycemic agents alone (OGA: N=12). Hemoglobin A1c (HbA1c) was measured. An insulin modified intravenous glucose tolerance test (modified‐IVGTT) was performed and the acute insulin response to glucose (AIRg) and insulin sensitivity (SI) were calculated using minimal model analysis. HbA1c (INS: 8.1±0.5 %; OGA: 6.5±0.2 %; p < 0.01) was higher in INS vs. OGA. AIRg (INS: 13±10 μU/ml; OGA: 131±45 μU/ml; p = 0.04) and SI (INS: 0.6±0.2; OGA: 1.9±0.3; p < 0.01) were lower in INS vs. OGA. Multiple stepwise linear regression revealed that SI explained 47% and AIRg 14% of the variance in HbA1c. These results suggest that both pancreatic function and insulin sensitivity are lower in T2D patients whose medications include insulin compared to patients on oral glycemic agents alone and that differences in insulin sensitivity explain more of the variance in glycemic control than differences in pancreatic function in type 2 diabetics. Supported by an East Carolina Diabetes and Obesity Institute (ECDOI) grant.