Insulin secretion and sensitivity as determinants of HbA1c in type 2 diabetes

European Journal of Clinical Investigation
L MonnierH Lapinski

Abstract

Defects in insulin secretion and sensitivity, two major determinants of glycaemic control, can occur and progress or not in parallel. The present study was designed to compare the respective roles of both determinants on HbA1c, in type 2 diabetic patients, according to whether or not residual beta-cell function was stimulated with insulin secretagogues. Insulin secretion and insulin sensitivity were both estimated using the homeostasis model assessment (HOMA). HbA1c, insulin sensitivity (HOMA2%S) and insulin secretion (HOMA2%B) were determined in 289 noninsulin-using type 2 diabetic patients who were further divided into two groups according to treatment: metformin alone (group I, n = 57) or metformin and glyburide (group II, n = 232). The patients of both groups were further divided into three subsets in order to test the dependence of HbA1c on HOMA2%B and HOMA2%S. In group I mean HbA1c were greater (8.4%) in patients with HOMA2%B < 50% than in the two subsets with HOMA2%B > or = 50%: 7.2 and 6.8% (P = 0.0013). In group II mean values of stimulated-insulin secretion (HOMA2%B) were lesser (40.7 and 30.1%) in the two subsets of patients with HbA1c > or = 8% than in patients with HbA1c < 8%: 55.1% (P < 0.0001). By contrast, we fo...Continue Reading

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Citations

Sep 10, 2008·Current Diabetes Reports·Louis Monnier, Claude Colette
Sep 26, 2015·Diabetes, Obesity & Metabolism·Surya Panicker RajeevJohn P H Wilding
Nov 26, 2009·Diabetic Medicine : a Journal of the British Diabetic Association·M TurzynieckaC D Byrne
Apr 19, 2018·Diabetes/metabolism Research and Reviews·Giuseppina T RussoUNKNOWN BetaDecline Study Group
Jun 29, 2007·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Abigail FraserDebbie A Lawlor
Aug 2, 2019·The British Journal of Nutrition·Júnia Maria Geraldo GomesRita de Cássia Gonçalves Alfenas
Oct 18, 2007·Current Opinion in Endocrinology, Diabetes, and Obesity
Oct 18, 2007·Current Opinion in Endocrinology, Diabetes, and Obesity

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