Lower beta cell function relates to sustained higher glycated albumin to glycated hemoglobin ratio in Japanese patients with type 2 diabetes

Saisho, Yoshifumi; Tanaka, Kumiko; Abe, Takayuki; Kawai, Takeshi; Itoh, Hiroshi

doi:10.1507/endocrj.ej13-0376

Cited by 19 publications

(13 citation statements)

References 35 publications

(33 reference statements)

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“…23−25 Thirdly, better β-cell function preservation in patients with OAD monotherapy may due to better baseline β-cell function, since worse baseline β-cell function per se is associated with worse metabolic control and higher hyperglycemia or hypoglycemia events. 26 Of note, unlike many studies which showed a protective effect of insulin therapies or insulin plus OAD for β-cell function preservation, 5,27 outcomes in this study demonstrated that β-cell function deteriorates irrespective of the insulin therapies in elderly T2DM patients. This phenomenon can be ascribed to the following reasons.…”

Section: Discussioncontrasting

confidence: 62%

Islet β-Cell Function Following 4.4-Year Insulin Injection in Chinese Elderly Patients with Type 2 Diabetes Mellitus

Wei

Huang

Xiao

et al. 2020

Preprint

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Background The aim of this study was to scrutinize changes of islet β-cell function in Chinese elderly patients with type 2 diabetes mellitus (T2DM) after insulin versus oral anti-diabetic (OAD) treatments.Methods In this prospective study, islet β-cell function was determined by oral glucose tolerance testderived fasting C-peptide, maximal C-peptide, C-peptide area under the curve (AUC c-pep ) and fasting c-pep /fasting glu , maximal c-pep /maximal glu , AUC c-pep /AUC glu . Differences in β-cell function indices between baseline and follow-up were compared among insulin monotherapy, OAD monotherapy and combined therapies. Results From 2009 to 2017, 419 elderly patients (men: 51.1%) with T2DM (insulin monotherapy, n=105; OAD monotherapy, n=172; insulin + OAD, n=142) had undergone baseline and follow-up βcell function assessment after a mean observation of 4.4 (range, 3.0 -7.2) years. Overall, islet β-cell function indices were decreased in all the three groups: insulin (fasting C-peptide: p=0.002; maximal C-peptide: p=0.005; fasting c-pep /fasting glu : p=0.015; maximal c-pep /maximal glu : p=0.031), OAD (fasting C-peptide: p=0.026; maximal C-peptide: p=0.013; fasting c-pep /fasting glu : p=0.025; maximal c-pep /maximal glu : p=0.029), insulin + OAD (fasting C-peptide: p<0.001; maximal Cpeptide: p<0.001; fasting c-pep /fasting glu : p=0.015; maximal c-pep /maximal glu : p=0.019). No significant differences of reduction were observed among the three groups regarding the fasting Cpeptide (p=0.437), fastingc-pep/fastingglu (p=0.598), maximalc-pep/maximalglu (p=0.756), AUCcpep (p=0.856) and AUCc-pep/AUCglu (p=0.912). However, the OAD treatment group had showed a less reduction level over insulin or insulin + OAD treatment.Conclusions In Chinese elderly patients with T2DM, islet β-cell function indices progressively decline regardless of insulin supplement or insulin plus OAD treatments. However, patients with OAD monotherapy may provide better β-cell function preservation than the insulin treatments. BackgroundThe effect of insulin therapy for islet β-cell function in patients with type 2 diabetes mellitus (T2DM) remains inconclusive. The United Kingdom Prospective Diabetes Study (UKPDS) has clearly showed that islet β-cell function deteriorates over time irrespective of any glucose lowering modalities,

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Section: Discussioncontrasting

confidence: 62%

Islet β-Cell Function Following 4.4-Year Insulin Injection in Chinese Elderly Patients with Type 2 Diabetes Mellitus

Wei

Huang

Xiao

et al. 2020

Preprint

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“…An inverse relationship between residual C-peptide level and GV has been reported in patients with T1DM [104,105,106]. We and others reported that an inverse relationship between beta cell function and GA to HbA1c ratio was observed in patients with T2DM [21,107,108,109,110] (Figure 3A), suggesting that less beta cell function is associated with greater postprandial glycemic excursion or GV in patients with T2DM. Interestingly, the relationship between beta cell function assessed by serum C-peptide and GA to HbA1c ratio was comparable between patients with type 1 and type 2 diabetes [21] (Figure 3B), suggesting that the relationship between serum C-peptide and GV is independent of the type of diabetes.…”

Section: Discussionmentioning

confidence: 52%

Glycemic Variability and Oxidative Stress: A Link between Diabetes and Cardiovascular Disease?

Saisho

2014

IJMS

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145

129

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Diabetes is associated with a two to three-fold increase in risk of cardiovascular disease. However, intensive glucose-lowering therapy aiming at reducing HbA1c to a near-normal level failed to suppress cardiovascular events in recent randomized controlled trials. HbA1c reflects average glucose level rather than glycemic variability. In in vivo and in vitro studies, glycemic variability has been shown to be associated with greater reactive oxygen species production and vascular damage, compared to chronic hyperglycemia. These findings suggest that management of glycemic variability may reduce cardiovascular disease in patients with diabetes; however, clinical studies have shown conflicting results. This review summarizes the current knowledge on glycemic variability and oxidative stress, and discusses the clinical implications.

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“…All measurements, unless otherwise indicated, were performed by the Department of Laboratory Medicine, Keio University School of Medicine using routine automated laboratory methods as previously described[ 16 , 17 ]. HbA1c was measured by high-performance liquid chromatography (HPLC), and the values were expressed as National Glycohemoglobin Standardization Program (NGSP) values in this paper[ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Efficacy and Safety of Sitagliptin Added to Insulin in Japanese Patients with Type 2 Diabetes: The EDIT Randomized Trial

et al. 2015

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AimsTo clarify the efficacy and safety of adding sitagliptin to insulin therapy in Japanese patients with suboptimally controlled type 2 diabetes (T2DM).Study Design and MethodsThis was a 24-week, prospective, randomized, open-labeled, controlled trial. Patients with T2DM who were suboptimally controlled despite receiving at least twice daily injection of insulin were enrolled in the study. The patients were randomized to continuation of insulin treatment (Insulin group) or addition of sitagliptin 50 to 100 mg daily to insulin treatment (Ins+Sita group). The primary outcome was change in HbA1c at week 24.ResultsAdding sitagliptin to insulin significantly reduced HbA1c from 7.9 ± 1.0% at baseline to 7.0 ± 0.8% at week 24 (P <0.0001), while there was no significant change in HbA1c in the Insulin group (7.8 ± 0.7% vs. 7.8 ± 1.1%, P = 0.32). The difference in HbA1c reduction between the groups was 0.9% (95% confidence interval, 0.4 to 1.5, P = 0.01). There was no significant weight gain in either group. Incidence of hypoglycemia was significantly reduced in the Ins+Sita group compared with the Insulin group. Treatment satisfaction was improved in the Ins+Sita group. Baseline HbA1c level and beta cell function were associated with the magnitude of reduction in HbA1c in the Ins+Sita group.ConclusionAdding sitagliptin to insulin reduced HbA1c without weight gain or increase in hypoglycemia, and improved treatment satisfaction in Japanese patients with T2DM who were suboptimally controlled despite at least twice daily injection of insulin.Trial RegistrationThe University Hospital Medical Information Network (UMIN) Clinical Trials Registry UMIN000004678

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Lower beta cell function relates to sustained higher glycated albumin to glycated hemoglobin ratio in Japanese patients with type 2 diabetes

Cited by 19 publications

References 35 publications

Islet β-Cell Function Following 4.4-Year Insulin Injection in Chinese Elderly Patients with Type 2 Diabetes Mellitus

Islet β-Cell Function Following 4.4-Year Insulin Injection in Chinese Elderly Patients with Type 2 Diabetes Mellitus

Glycemic Variability and Oxidative Stress: A Link between Diabetes and Cardiovascular Disease?

Efficacy and Safety of Sitagliptin Added to Insulin in Japanese Patients with Type 2 Diabetes: The EDIT Randomized Trial

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