Original Data
| Rev Diabet Stud,
2010,
7(3):225-232 |
DOI 10.1900/RDS.2010.7.225 |
Effects of Insulin Versus Sulphonylurea on Beta-Cell Secretion in Recently Diagnosed Type 2 Diabetes Patients: A 6-Year Follow-Up Study
Michael Alvarsson1, Kerstin Berntorp2, Eva Fernqvist-Forbes3, Ibe Lager4, Lars Steen5, Thomas Örn6, Valdemar Grill1,7
1Department of Endocrinology and Diabetology, Karolinska University Hospital, Stockholm, Sweden
2Department of Endocrinology, Malmö University Hospital, Malmö, Sweden
3Department of Medicine, Visby Hospital, Visby, Sweden
4Department of Medicine, Kristianstad Hospital, Kristianstad, Sweden
5Department of Medicine, Mälarsjukhuset, Eskilstuna, Sweden
6Department of Medicine, Blekingesjukhuset, Karlskrona, Sweden
7Department of Internal Medicine, St. Olav University Hospital, Trondheim, Norway
Address correspondence to: Michael Alvarsson, e-mail: michael.alvarsson@karolinska.se
Manuscript submitted October 8, 2010; resubmitted November 4, 2010; accepted November 7, 2010.
Keywords: type 2 diabetes, beta-cell function, insulin secretion, sulphonylurea, islet amyloid polypeptide
Abstract
BACKGROUND: Early insulin treatment is considered more beneficial than anti-diabetic medication with sulphonylureas, because the latter may exert negative effects on beta-cell function, while the former may help preserve it. In a previous study, we found that C-peptide response was increased in the insulin-treated group, whereas it was decreased in the glibenclamide group. However, it was not certain whether the advantage remained in the longer term. AIM: In this study, we tested whether early insulin treatment is more beneficial than glibenclamide against a 6-year follow-up perspective. METHODS: We designed a randomized clinical trial in subjects with newly diagnosed type 2 diabetes. Glucagon stimulatory tests, measuring C-peptide and islet amyloid polypeptide (IAPP), were performed after 2, and 3, days of temporary insulin and glibenclamide withdrawal. RESULTS: 18 subjects initially randomized to glibenclamide, and 16 randomized to two daily injections of insulin, participated in end-of-study investigations. C-peptide response to glucagon deteriorated (p < 0.01 vs. baseline) in initially glibenclamide-treated patients (n = 18), but not in insulin-treated patients (p < 0.05 for difference between groups, after 2 days of treatment withdrawal). The IAPP response to glucagon declined in the glibenclamide group (p < 0.001), but not in insulin-treated subjects (p = 0.05 for difference between groups). CONCLUSIONS: Early insulin treatment preserves beta-cell secretory function better than glibenclamide even in a 6-year perspective.
Fulltext:
 HTML ,  PDF
(124KB)
This article has been cited by other articles:
|
