Marked recovery from glucotoxicity of β-cell function after medical nutrition therapy without pharmacotherapy in type 2 diabetic outpatients with extreme hyperglycemia: a pilot retrospective study

<p>Investigation of the Effect of Canagliflozin on the Disposition Index, a Marker of Pancreatic Beta Cell Function, in Patients with Type 2 Diabetes</p>

“…We previously reported that medical nutrition therapy without pharmacotherapy aided the recovery of DI in patients with newly diagnosed type 2 diabetes presenting with extreme hyperglycemia and also show the correlation between DI and HbA1c. 10 Consistently, we found a correlation between the improvements in DI and glucose control in a population of patients with more advanced diabetes. A number of cross-sectional studies and an interventional study have documented an association between beta cell function and glycemic variability.…”

“…DI was calculated as (IAUC Ins0-120 /IAUC Glu0-120 ) × (Matsuda index), where IAUC Ins0-120 and IAUC glu0-120 are the incremental areas under the insulin and glucose curves, respectively, from 0 to 120 min. 10,24,25,27 As the insulin secretion index and Matsuda index (index of insulin resistance) tend to be influenced by SGLT2 inhibitors, 25 wash-out of the SGLT2 inhibitor is needed to evaluate the change in beta cell function after treatment. The effect of canagliflozin (100 mg) on urinary glucose excretion is mostly abolished by 3 days after stopping administration.…”

“…[6][7][8] However, once hyperglycemia is appropriately corrected, it may be possible to eliminate glucotoxicity and ameliorate pancreatic beta cell function. 9,10 Therefore, it is important to preserve beta cell function using appropriate antihyperglycemic agents.…”

Improvement of beta-cell function in conjunction with glycemic control after medical nutrition therapy in newly-diagnosed type 2 diabetes mellitus

“…In this sense, beta-cell function will not follow monotonous decrease but rather be variable to some extent. Our previous pilot study of 14 patients newly diagnosed with type 2 diabetes mellitus suggested that beta-cell function could be improved together with glycemic control, weight control, and insulin sensitivity after MNT, even without any aid of antihyperglycemic medications including exogenous insulin administration [ 5 ]. However, our previous study mainly focused on the change of beta-cell function after MNT in patients with considerably poor glycemic control; the study population was limited to patients with baseline hemoglobin A1c (HbA1c) levels of 8% (64 mmol/mol) or higher, and the correlation was only assessed between beta-cell function and glycemic control after MNT.…”