Evidence of Restoration of both pancreatic β-Cell and α-Cell Function in Type 2 Diabetes

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 839-872-Diabetes & Obesity Management
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-872
Zhili Wang*1, Mohammad A Ghatei2, Nima Khandan-Nia2, Haiyan Xiong1, Qianyi Tang1, Fang Li1, Tu Ya Sa Ren1, Rui Yun1, Yu Song Dai1, Li Jie Geng1, Mozong Tang1, Li Zhao1, Hongmei Miao1 and Yanxia Wang1
1Beijing ChaoYang Diabetes Hospital, Beijing, China, 2Imperial College, London, United Kingdom
In patients with type 2 diabetes, we investigated whether pancreatic α-Cell and β-cell function can be improved by combining intensive insulin therapy with enhancement of microcirculation and repair of the trophic nerve system.

Thirty-seven subjects, randomly selected from patients with type 2 diabetes, were hospitalized and treated with insulin, in combination with microcirculation and trophic nerve therapy for 2 weeks. Post-treatment, patients exhibited excellent glycemic control, with reduction in insulin requirements. The patients were followed up for 6 months to evaluate their long-term islet function improvement. β-cell and α-cell function was assessed. During an OGTT test blood glucose, insulin, glucagon, and C-peptide were measured fasting and at 30, 60 min 120 min, 180 min time points. Fasting HbA1C and GSP were also measured on the same day.

After the 2-week therapy period patients lost 3.4±2.9 kg body weight, glucose area under the curve (AUCG) show significantly reduced by 25.6% (from 62.6 ±10.0 mmol/L/min to 46.6±11.8 mmol/L/min, P < 0.01) and insulin requirements were also significantly reduced by 79.3% (0.29±0.21 units kg-1 day-1 before treatment vs. 0.06±0.01 units kg-1 day-1 after treatment, P < 0.01). During the 6 month follow up, HbA1C and GSP levels were maintained within the normal range. C-peptide area under the curve (AUCC) and the ratio of AUCC to AUCG, indicators of β-cell function, showed significant increases 15.6% and 39.1% separately (P< 0.01). An increase of C-peptide concentration was shown at the 30 min or 60 min time points of the OGTT test (△Cp30/△Glu30 and △Cp60/△Glu60). Furthermore, there was a significant improvement in the homeostasis model assessment (HOMA) sensitivity and HOMA for insulin resistance (HOMA-IR), from 7.66 to 6.69. In addition, patients had greater suppression of plasma glucagon during the OGTT, at the 30 min, 60 min, 120 min and 180 min time points after a meal than at fasting.

In conclusion, this study, for the first time, has demonstrated that a 2-week therapy can restore β-cell and α-cell functions and significantly improve insulin sensitivity in type 2 diabetic patients over a six month period.

Nothing to Disclose: ZW, MAG, NK, HX, QT, FL, TYSR, RY, YSD, LJG, MT, LZ, HM, YW

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

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