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The effects of short-term continuous subcutaneous insulin infusion treatment on fasting glucagon-like peptide-1 concentrations in newly diagnosed type 2 diabetes

  • Xiaofei Huang
    Affiliations
    Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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  • Sha Li
    Affiliations
    Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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  • Mei Yang
    Affiliations
    Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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  • Xuquan Fu
    Affiliations
    Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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  • Huaqi Li
    Affiliations
    Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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  • Tong Yan
    Affiliations
    Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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  • Yidong Liu
    Affiliations
    Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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  • Lihong Chen
    Affiliations
    Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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  • Lingsheng Lan
    Affiliations
    Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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  • Libo Li
    Affiliations
    Department of Hematology, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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  • Xiaowei Zhong
    Correspondence
    Corresponding author at: Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, No. 82 Qinglong Street, Chengdu 610031, China.
    Affiliations
    Department of Endocrinology and Metabolism, The Third People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
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Published:February 03, 2018DOI:https://doi.org/10.1016/j.diabres.2018.01.033

      Highlights

      • Satisfactory glycemic control is obtained by CSII treatment.
      • β-cell function and GLP-1 concentration improve significantly after treatment.
      • Overweight and middle-aged patient may get more benefit from the treatment.

      Abstract

      Objective

      Early short-term intensive insulin therapy in newly diagnosed type 2 diabetes patients shows benefit in glycemic control and β-cell function. Glucagon-like peptide-1 (GLP-1) plays an important role in glucose metabolism and development of type 2 diabetes. We did a study to observe the changes of GLP-1 and β-cell function after short-term continuous subcutaneous insulin infusion (CSII) treatment.

      Methods

      A total of 66 subjects were enrolled, including 30 normal glucose tolerance controls (NGT) and 36 patients with newly diagnosed type 2 diabetes between October 2015 and July 2016. Fasting plasma glucose (FPG), insulin, and GLP-1 were measured in each subject. The patients underwent CSII treatment for 2 weeks, and then FBG, insulin, and GLP-1 were measured. HOMA-IR and HOMA-B were then calculated.

      Results

      All patients achieved target glycemic control in two weeks. HOMA-IR and HOMA-B improved significantly after intensive interventions (p < 0.05). The GLP-1 concentration increased significantly in patients after treatment (p < 0.05). When grouped according to bodyweight and age in all patients, the HOMA-IR changed significantly in overweight and old age subgroups, the HOMA-B increased significantly in normal weight, overweight and middle age subgroups, and the GLP-1 concentration also increased significantly in overweight and middle age subgroups respectively (p < 0.05).

      Conclusion

      Short-term CSII treatment can obtain glycemic control target and recover β-cell function and GLP-1 secretion in newly diagnosed type 2 diabetes patients. The overweight and middle-aged patients may get more benefit from this treatment.

      Keywords

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      References

        • Whiting D.R.
        • et al.
        IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030.
        Diabetes Res Clin Pract. 2011; 94: 311-321
      1. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998;352(9131):837–53.

        • Ilkova H.
        • et al.
        Induction of long-term glycemic control in newly diagnosed type 2 diabetic patients by transient intensive insulin treatment.
        Diabetes Care. 1997; 20: 1353-1356
        • Kramer C.K.
        • Zinman B.
        • Retnakaran R.
        Short-term intensive insulin therapy in type 2 diabetes mellitus: a systematic review and meta-analysis.
        Lancet Diabetes Endocrinol. 2013; 1: 28-34
      2. Standards of medical care in diabetes-2016: summary of revisions. Diabetes Care, 2016;39 (Suppl. 1):S4-5.

      3. Implementation of treatment protocols in the Diabetes Control and Complications Trial. Diabetes Care 1995;18(3):361–76.

        • Jin S.L.
        • et al.
        Distribution of glucagonlike peptide I (GLP-I), glucagon, and glicentin in the rat brain: an immunocytochemical study.
        J Comp Neurol. 1988; 271: 519-532
        • Drucker D.J.
        The biology of incretin hormones.
        Cell Metab. 2006; 3: 153-165
        • Buse J.B.
        • et al.
        Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6).
        Lancet. 2009; 374: 39-47
        • Perloff D.
        • et al.
        Human blood pressure determination by sphygmomanometry.
        Circulation. 1993; 88: 2460-2470
        • Zhou B.F.
        Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults–study on optimal cut-off points of body mass index and waist circumference in Chinese adults.
        Biomed Environ Sci. 2002; 15: 83-96
      4. World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee. J Hypertens 1999:17(2);151–83.

      5. Stone NJ et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63(25 Pt B):2889–934.

        • Levy J.C.
        • Matthews D.R.
        • Hermans M.P.
        Correct homeostasis model assessment (HOMA) evaluation uses the computer program.
        Diabetes Care. 1998; 21: 2191-2192
        • Wajchenberg B.L.
        Beta-cell failure in diabetes and preservation by clinical treatment.
        Endocr Rev. 2007; 28: 187-218
        • Weng J.
        • et al.
        Effect of intensive insulin therapy on beta-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes: a multicentre randomised parallel-group trial.
        Lancet. 2008; 371: 1753-1760
        • Cersosimo E.
        • et al.
        Assessment of pancreatic beta-cell function: review of methods and clinical applications.
        Curr Diabetes Rev. 2014; 10: 2-42
        • Salehi M.
        • et al.
        Effect of endogenous GLP-1 on insulin secretion in type 2 diabetes.
        Diabetes. 2010; 59: 1330-1337
        • Zhang F.
        • et al.
        Impaired secretion of total glucagon-like peptide-1 in people with impaired fasting glucose combined impaired glucose tolerance.
        Int J Med Sci. 2012; 9: 574-581
        • Toft-Nielsen M.B.
        • et al.
        Determinants of the impaired secretion of glucagon-like peptide-1 in type 2 diabetic patients.
        J Clin Endocrinol Metab. 2001; 86: 3717-3723
        • Faerch K.
        • et al.
        GLP-1 response to oral glucose is reduced in prediabetes, screen-detected type 2 diabetes, and obesity and influenced by sex: the aDDITION-PRO study.
        Diabetes. 2015; 64: 2513-2525
        • Calanna S.
        • et al.
        Secretion of glucagon-like peptide-1 in patients with type 2 diabetes mellitus: systematic review and meta-analyses of clinical studies.
        Diabetologia. 2013; 56: 965-972
        • Perry I.J.
        • et al.
        Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men.
        BMJ. 1995; 310: 560-564
        • Geloneze B.
        • et al.
        Impaired incretin secretion and pancreatic dysfunction with older age and diabetes.
        Metabolism. 2014; 63: 922-929
        • Saydah S.H.
        • Fradkin J.
        • Cowie C.C.
        Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes.
        JAMA. 2004; 291: 335-342
        • Haffner S.M.
        • et al.
        Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes?.
        JAMA. 1990; 263: 2893-2898