Original Article
Effect on prognosis in type 2 diabetic patients of the changes of islet β-cell function during short-term continuous subcutaneous insulin infusion
Juan Liu, Tuladhar Jasmeen, Weijian Ke, Wanping Deng, Jianbin Liu, Xiaopei Cao, Yanbing Li
Published 2014-05-27
Cite as Chin J Diabetes Mellitus, 2014, 06(5): 293-298. DOI: 10.3760/cma.j.issn.1674-5809.2014.05.005
Abstract
ObjectiveTo explore the changes in islet β-cell function during continuous subcutaneous insulin infusion (CSII) in type 2 diabetic patients and to observe the possible relationship between these changes and the improvement of β-cell function after CSII.
MethodsA total of 36 type 2 diabetic patients were enrolled from January 15, 2013 to March 20, 2013. After hospitalized, fasting blood was collected for basic biochemical tests, lipid profile, HbA1c, and arginine stimulated C-peptide(CP) test was performed. Then the patients were recruited to 9-13 days CSII therapy. The arginine stimulated CP test was repeated during and after CSII. The decreasing amplitudes of fasting C peptide(FCP) and the increment of CP(indicated by ΔFCP%, ΔCPi%) after arginine during CSII were calculated, in which the correlations between the two indexes and the CP levels after CSII were observed. Data analysis were performed using SPSS 16.0.
ResultsAfter the brief course of CSII therapy, fasting plasma glucose level fell from (13.6±3.7) to (6.6±1.5) mmol/L(t=9.374, P<0.05), and the level of FCP increased significantly ((0.71±0.30) vs (0.62±0.29) pmol/L, t=2.854, P<0.05). During CSII, both FCP level and the increment of CP (CPi) after stimulating of arginine evidently decreased, compared with those before and after CSII (FCP: at target (0.25±0.20) pmol/L vs before treatment (0.62±0.29) pmol/L, after treatment (0.71±0.30) pmol/L, t=-9.153, -11.021, P<0.05; CPi: at target(0.37±0.30) pmol/L vs before treatment(0.58±0.41) pmol/L, after treatment(0.52±0.30) pmol/L, t=-6.201, -4.856, P<0.05). In the multiple linear regression analysis, after the adjustment for age, blood glucose, duration, BMI and creatinine clearance rate, ΔFCP% and ΔCPi% were independently related to CPi after CSII treatment (standardized β values: -0.329, -0.334, P<0.05).
ConclusionsCSII can provide a useful therapeutic strategy for speedy, stable glycemic control and improving the retained β-cell function in type 2 diabetes patients. During CSII, the β-cell function is suppressed significantly, which can recover rapidly after the end of CSII and the decreasing amplitude of β-cell function is negatively correlated with the improvement of that after CSII.
Key words:
Diabetes mellitus, type 2; Insulin infusion system; C peptide
Contributor Information
Juan Liu
Department of Endocrinology and Diabetes Centre, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Tuladhar Jasmeen
Weijian Ke
Wanping Deng
Jianbin Liu
Xiaopei Cao
Yanbing Li
