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Thiazolidinediones improve β-cell function in type 2 diabetic patients.
- Source :
- American Journal of Physiology: Endocrinology & Metabolism; Mar2007, Vol. 292, pE871-E883, 13p, 4 Charts, 6 Graphs
- Publication Year :
- 2007
-
Abstract
- Thiazolidinediones (TZDs) improve glycemic control and insulin sensitivity in patients with type 2 diabetes mellitus (T2DM). There is growing evidence from in vivo and in vitro studies that TZDs improve pancreatic β-cell function. The aim of this study was to determine whether TZD-induced improvement in glycemic control is associated with improved β-cell function. We studied 11 normal glucose-tolerant and 53 T2DM subjects [age 53 ± 2 yr; BMI 29.4 ± 0.8 kg/m² fasting plasma glucose (FPG) 10.3 ± 0.4 mM; Hb A<subscript>1c</subscript> 8.2 ± 0.3%]. Diabetic patients were randomized to receive placebo or TZD for 4 mo. Subjects received 1) 2-h OGTT with determination of plasma glucose, insulin, and C-peptide concentrations and 2) two-step euglycemic insulin (40 and 160 mU·m<superscript>-2</superscript>min<superscript>-1</superscript>) clamp with [3-³H]glucose. T2DM patients were then randomized to receive 4 mo of treatment with pioglitazone (45 mg/day), rosiglitazone (8 mg/day), or placebo. Pioglitazone and rosiglitazone similarly improved FPG, mean plasma glucose during OGTT, Hb A<subscript>1c</subscript>, and insulin-mediated total body glucose disposal (R<subscript>d</subscript>) and decreased mean plasma FFA during OGTT (all P < 0.01, ANOVA). The insulin secretion/insulin resistance (disposition) index [ΔSR(AUC)/Δglucose(AUC) ÷ IR] was significantly improved in all TZD-treated groups: + 1.8 ± 0.7 (PlO + drug-naive diabetics), +0.7 ± 0.3 (PlO + sulfonylurea-treated diabetics), and 0.7 ± 0.2 (ROSI + sulfonylurea-withdrawn diabetics) vs. -0.2 ± 0.3 in the two placebo groups (P < 0.01, all TZDs vs. placebo, ANOVA). Improved insulin secretion correlated positively with increased body weight, fat mass, and R<subscript>d</subscript> and inversely with decreased plasma glucose and FFA during the OGTT In T2DM patients, TZD treatment leads to improved β-cell function, which correlates strongly with improved glycemic control. [ABSTRACT FROM AUTHOR]
- Subjects :
- KETONES
TYPE 2 diabetes
BLOOD sugar
INSULIN
PANCREATIC secretions
Subjects
Details
- Language :
- English
- ISSN :
- 01931849
- Volume :
- 292
- Database :
- Complementary Index
- Journal :
- American Journal of Physiology: Endocrinology & Metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 24515002
- Full Text :
- https://doi.org/10.1152/ajpendo.00551.2006