Hyperglycaemia is associated with impaired pulsatile insulin secretion: effect of basal insulin therapy

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2013-03, Vol.15 (3), p.258-263
• Main Authors: Meier, J. J., Pennartz, C., Schenker, N., Menge, B. A., Schmidt, W. E., Heise, T., Kapitza, C., Veldhuis, J. D.
• Format: Article
• Language: English
• Subjects: Blood Glucose - drug effects; Blood Glucose - metabolism; C-Peptide - metabolism; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - physiopathology; Female; Humans; Hyperglycemia - blood; Hyperglycemia - drug therapy; Hyperglycemia - metabolism; Hyperglycemia - physiopathology; Insulin - blood; Insulin - metabolism; Insulin Glargine; Insulin Secretion; insulin therapy; Insulin, Long-Acting - metabolism; Male; Middle Aged; Postprandial Period; Treatment Outcome; β-cell
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.12022

Aim Postprandial insulin pulsatility is impaired in patients with type 2 diabetes, but the effects of exogenous insulin therapy on pulsatile insulin secretion are not known. We addressed, whether pulsatile insulin secretion is related to glycaemic control, whether basal insulin supplementation increases postprandial insulin secretion, and if so, is this accomplished by a specific improvement in pulsatile insulin secretion? Methods Fourteen patients with type 2 diabetes underwent a mixed meal test before and after an 8‐week treatment period with insulin glargine. Glucose, insulin and C‐peptide levels were measured, and insulin pulsatility was determined by deconvolution analysis. Results Insulin treatment lowered fasting glycaemia from 179.6 ± 7.5 mg/dl to 117.6 ± 6.5 mg/dl (p