Title: Insulin Supplement in Type 2 Diabetic Patients with Secondary Failure to Oral Agents Ameliorates Hepatic and Peripheral Insulin Sensitivity but not Insulin Secretion
Abstract: In order to investigate the mechanism of amelioration of metabolic abnormalities with supplementary doses of insulin, islet B‐cell function and insulin sensitivity were measured in 10 patients with Type 2 diabetes in secondary failure to oral agents. A small dose of ultralente insulin (0.26 ± 0.07 U kg‐ideal‐body‐weight −1 ) was added in the morning before breakfast. After 3 months insulin therapy and progressive improvement of metabolic control (HbA 1 from 10.5 ± 0.4 to 9.0 ± 0.3 % at the end of insulin treatment, p < 0.001), basal C‐peptide and incremental area during an oral glucose tolerance test were unchanged. In vivo peripheral insulin sensitivity (euglycaemic clamp with insulin infusion of 40, 160, and 600 mU m −2 min −1 , respectively) was significantly improved (glucose requirement: to 4.7 ± 1.0 from 3.0 ± 0.6 mg kg −1 min −1 , p< 0.05 at first insulin level; to 10.8 ± 0.5 from 9.3 ± 0.7 mg kg −1 min −1 , p<0.01 at second level; to 13.3 ± 0.6 from 11.8 ± 0.8 mg kg −1 min −1 , p< 0.025 at third level). Basal hepatic glucose production was also significantly reduced (from 4.3 ± 0.4 to 3.3 ± 0.3 mg kg −1 min −1 , p< 0.05), and residual glucose production further suppressed after insulin supplement (from 1.1 ± 0.4 to 0.3 ± 0.2 mg kg −1 min −1 after 120 min at 100 mU I −1 plasma insulin, p< 0.05). Specific insulin binding to mononuclear leucocytes was unchanged (from 3.1 ± 0.3 to 3.5 ± 0.3 %, NS).
Publication Year: 1990
Publication Date: 1990-11-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 3
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