Insulin Action and Insulin Secretion in Newly Diagnosed Type 2 Diabetic Patients

新診斷第二型糖尿病病人胰島素之作用及分泌

曾競鋒(Thing-Fong Tzeng) ； 陳政宏(Jenq-Horng Chen) ； 蕭璧容(Pi-Jung Hsiao) ； 謝明家(Ming-Chia Hsieh) ； 辛錫璋(Shyi-Jang Shin)

《The Kaohsiung Journal of Medical Sciences》 17卷9期 (2001/09) Pp. 468-474

https://doi.org/10.6452/KJMS.200109.0468

摘要

To clarify the insulin action and insulin secretion in newly diagnosed type 2 diabetic subjects, we investigated insulin and C-peptide response to an oral glucose tolerance test (OGTT) in 15 newly diagnosed type 2 diabetic patients and 17 healthy subjects. For insulin action, we found fasting hyperinsulinemia (8.4±0.8 vs. 6.0±0.5μIU/ml, p=0.014), higher insulin resistance by homeostasis model assessment (HOMA) (4.33±0.2 vs. 1.34±0.1 μIU/ml‧mmol/l, P＜0.00l), and lower insulin sensitivity index (ISI) (51.0±0.7 vs. 104.0±0.8, p＜0.001) in newly diagnosed diabetic patients compared to normal subjects. For insulin secretion, the increments of AVCI (area under curve of insulin) and AVCC-P (area under curve of C-peptide) (increment of AVCI: 26.1±1.4 vs. 82.8±4.5μIU/ml‧hour, p＜0.001; increment of AUCC-P: 3.9±0.2 vs. 11.4±0.6 ng/ml‧hour, p＜0.001), insulin secretion by HOMA model (20.7±1.2 vs. 79.1±3.8 IU/mol, p＜0.001), and ratio of 30 min increment of fasting insulin to glucose during OGTT (1.14±0.1 vs. 13.1±0.5 IU/mol, p＜0.001) were significantly lower in the newly diagnosed diabetic patients than normal subjects. In addition, body mass index (BMI) in our type 2 diabetes is relatively lower (24±0.65 kg/m2) than those in western countries. These findings revealed poor insulin action and decreased insulin secretion in relatively less obese Taiwanese with newly diagnosed type 2 diabetes.

並列摘要

To clarify the insulin action and insulin secretion in newly diagnosed type 2 diabetic subjects, we investigated insulin and C-peptide response to an oral glucose tolerance test (OGTT) in 15 newly diagnosed type 2 diabetic patients and 17 healthy subjects. For insulin action, we found fasting hyperinsulinemia (8.4±0.8 vs. 6.0±0.5μIU/ml, p=0.014), higher insulin resistance by homeostasis model assessment (HOMA) (4.33±0.2 vs. 1.34±0.1 μIU/ml‧mmol/l, P＜0.00l), and lower insulin sensitivity index (ISI) (51.0±0.7 vs. 104.0±0.8, p＜0.001) in newly diagnosed diabetic patients compared to normal subjects. For insulin secretion, the increments of AVCI (area under curve of insulin) and AVCC-P (area under curve of C-peptide) (increment of AVCI: 26.1±1.4 vs. 82.8±4.5μIU/ml‧hour, p＜0.001; increment of AUCC-P: 3.9±0.2 vs. 11.4±0.6 ng/ml‧hour, p＜0.001), insulin secretion by HOMA model (20.7±1.2 vs. 79.1±3.8 IU/mol, p＜0.001), and ratio of 30 min increment of fasting insulin to glucose during OGTT (1.14±0.1 vs. 13.1±0.5 IU/mol, p＜0.001) were significantly lower in the newly diagnosed diabetic patients than normal subjects. In addition, body mass index (BMI) in our type 2 diabetes is relatively lower (24±0.65 kg/m2) than those in western countries. These findings revealed poor insulin action and decreased insulin secretion in relatively less obese Taiwanese with newly diagnosed type 2 diabetes.

並列關鍵字

insulin action ； insulin secretion ； C-peptide ； OGTT ； newly diagnosed type 2DM