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Defective beta-cell function, insulin resistance found in newly diagnosed diabetes
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Defective beta-cell function and insulin resistance are commonly found among patients with newly diagnosed type 2 diabetes, and their presence alone or in combination may be related to phenotype, according to study results presented at the 51st European Association for the Study of Diabetes Annual Meeting.
“As clinical phenotype varies according to the type 2 diabetes pathogenic defect, our findings may be relevant to therapeutic strategies centered on the metabolic phenotype of the patients,” Marco Dauriz, MD, of the University of Verona in Italy, told Endocrine Today. “It might be interesting in follow-up studies to verify whether therapeutic regimens employed in light of the phenotype assessed at diagnosis might have changed — or solely delayed — the natural history of diabetes.”
Marco Dauriz
Dauriz and colleagues evaluated 712 glutamic acid decarboxylase 65 antibody (GADA)–negative, drug-naïve patients with newly diagnosed type 2 diabetes from the Verona Newly Diagnosed Type 2 Diabetes Study (VNDS) to determine beta-cell function and insulin resistance. Researchers evaluated insulin sensitivity by euglycemic insulin clamp and beta-cell function by modelling of the prolonged (5 hours) oral glucose tolerance test (OGTT)–derived glucose/C-peptide curves.
Overall, 89.8% of participants had beta-cell dysfunction, 87.8% had insulin resistance and 19.7% had only one defect.
Eleven percent of participants had isolated beta-cell dysfunction, and 8.9% had isolated insulin resistance. Nearly 80% of participants had coexisting beta-cell dysfunction and insulin resistance. No detectable alterations in beta-cell function and insulin sensitivity were found in 1.4% of participants.
Lower BMI, fasting glucose, HbA1c and triglycerides as well as higher HDL-cholesterol and insulin sensitivity were found among participants with only one metabolic defect compared with participants with beta-cell dysfunction together with insulin resistance (P < .01).
“In summary, at the time of diagnosis of type 2 diabetes, defective beta-cell function comorbid with insulin resistance was present in a large proportion of VNDS patients,” Dauriz said. “A milder accompanying metabolic phenotype characterized those with only one pathogenic defect. The presence of either insulin resistance or beta-cell dysfunction alone seems to be sufficient to lead to overt diabetes.” – by Amber Cox
Reference:
Dauriz M, et al. Abstract #85. Presented at: 51st EASD Annual Meeting; Sept. 14-18, 2015; Stockholm.
Disclosure: The researchers report no relevant financial disclosures.