In:
Diabetes/Metabolism Research and Reviews, Wiley, Vol. 30, No. 8 ( 2014-11), p. 767-776
Abstract:
Few studies have measured the ability of interventions to affect declining β ‐cell function in screen‐detected type 2 diabetes. The Early Diabetes Intervention Programme (ClinicalTrials.gov NCT01470937) was a randomized study based on the hypothesis that improving postprandial glucose excursions with acarbose would slow the progression of fasting hyperglycaemia in screen‐detected type 2 diabetes. In the Early Diabetes Intervention Programme, the effect of acarbose plus lifestyle advice on progression of fasting hyperglycaemia over a 5‐year period was not greater than that of placebo. However, there was an early glucose‐lowering effect of the trial. The objective of the current secondary analysis was to describe β ‐cell function changes in response to glucose lowering. Methods Participants were overweight adult subjects with screen‐detected type 2 diabetes. β ‐cell function was measured using hyperglycaemic clamps and oral glucose tolerance testing. The primary outcome was the change in β ‐cell function from baseline to year 1, the time point where the maximal glucose‐lowering effect was seen. Results At baseline, participants exhibited markedly impaired first‐phase insulin response. Despite significant reductions in weight, fasting plasma glucose (PG) and 2‐h PG, there was no clinically significant improvement in the first‐phase insulin response. Late‐phase insulin responses declined despite beneficial glycaemic effects of interventions. Conclusions Insulin secretion is already severely impaired in early, screen‐detected type 2 diabetes. Effective glucose‐lowering intervention with acarbose was not sufficient to improve insulin secretion or halt the decline of β ‐cell function. Copyright © 2014 John Wiley & Sons, Ltd.
Type of Medium:
Online Resource
ISSN:
1520-7552
,
1520-7560
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2001565-3
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