Authors: Hsieh, Chang-Hsun¹; Hung, Yi-Jen¹; He, Chih-Tseung¹; Lee, Chien-Hsing¹; Hung, Szu-Chun²; Wang, Yi-Kuan³; Kuo, Shi-Wen⁴; Pei, Dee⁴

Source: Endocrine Research, Volume 31, Number 2, 2005 , pp. 149-158(10)

Publisher: Informa Healthcare

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 A 1c 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.

Keywords: Acute insulin response; Glucose sensitivity; Glucose toxicity; Insulin sensitivity; Intravenous glucose tolerance test

Document Type: Research article

DOI: http://dx.doi.org/10.1080/07435800500320661

Affiliations: 1: Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China 2: Division of Nephrology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Taipei, Taiwan, Republic of China 3: Nursing Department, Buddhist Tzu Chi General Hospital, Taipei, Taiwan, Republic of China 4: Division of Endocrinology and Metabolism, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Taipei, Taiwan, Republic of China

Publication date: 2005-01-01

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