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01-04-2020 | Insulins | Original Article

Impact of acute-phase insulin secretion on glycemic variability in insulin-treated patients with type 2 diabetes

Authors: Yiming Si, Yun Shen, Jingyi Lu, Xiaojing Ma, Lei Zhang, Yifei Mo, Wei Lu, Wei Zhu, Yuqian Bao, Gang Hu, Jian Zhou

Published in: Endocrine | Issue 1/2020

Abstract

Aims

The association between β-cell function and glycemic variability remains to be clarified in insulin-treated patients with type 2 diabetes. Therefore, the study sought to examine the association of various indices of β-cell function with glycemic variability in Chinese insulin-treated patients with type 2 diabetes.

Methods

Glycemic variability was assessed by the coefficient of variation (CV) of glucose levels with the use of continuous glucose monitoring (CGM). Basal β-cell function was evaluated by fasting C-peptide (FCP) and the homeostasis model assessment 2 for β-cell function (HOMA2-%β). Postload β-cell function was measured by 2-hour C-peptide (2hCP) and the acute C-peptide response (ACPR) to arginine.

Results

When a cutoff value of CV ≥ 36% was used to define unstable glucose, the multivariable-adjusted odds ratios for labile glycemic control were 0.34 (95% CI 0.18–0.64) for each 1 ng/mL increase in ACPR, 0.47 (95% CI 0.27–0.81) for each 1 ng/mL increase in FCP, 0.77 (95% CI 0.61–0.97) for each 1 ng/mL increase in 2hCP, and 1.00 (95% CI 0.98–1.01) for each 1% increase in HOMA2-%β. When we further adjusted for 2hCP and HOMA2-%β in the ACPR and FCP analyses, and adjusted for ACPR or FCP in the 2hCP analyses, only ACPR but not FCP or 2hPC remained to be a significant and inverse predictor for labile glycemic control.

Conclusions

ACPR evaluated by the arginine stimulation test may be superior to other commonly used β-cell function parameters to reflect glycemic fluctuation in insulin-treated patients with type 2 diabetes.

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Title: Impact of acute-phase insulin secretion on glycemic variability in insulin-treated patients with type 2 diabetes
Authors: Yiming Si
Yun Shen
Jingyi Lu
Xiaojing Ma
Lei Zhang
Yifei Mo
Wei Lu
Wei Zhu
Yuqian Bao
Gang Hu
Jian Zhou
Publication date: 01-04-2020
Publisher: Springer US
Keywords: Insulins
Insulins
Type 2 Diabetes
Published in: Endocrine / Issue 1/2020
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-020-02201-y

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