Insulin Eesponse to a Standardized Meal Improved in Well Controlled Type 2 Diabetes Patients

摘要

Background: Pathogenesis of type 2 diabetes is a complex process and in most instances requires defects in both B-cell function and insulin sensitivity. In type 2 diabetes patients (T2DM), there is impaired of first phase insulin response, while the second phase insulin response is diminished.Objective: The present study examined the effect of glycaemie control on post prandial insulin after a standardized meal among Type 2 diabetes patients with good and poor glycemic control.Design: Cross sectional.Methods and Results: We studied 31 Type 2 diabetes patients (T2DM) with good glycemic control and 32 T2DM patients with poor glycemic control. Subjects were given, after minimum 10 hours of fasting, a standard meal containing 857.5 kcal of energy. Fasting and serial postprandial blood samples were taken over 8 hours to determine levels of insulin and blood glucose (every 30 minutes for 3 hours i.e. from 1st to 7th sample; then hourly i.e. from 8~(th) sample to 12~(th) sample).Results: Although the difference in Insulin between the 2 groups did not reach statistical significance (P = 0.058), post-hoc analysis showed significant difference between the 2 groups from fasting (1" sample) to 1 hour post prandial (3rd sample), with P = 0.034. Postprandial glucose was significantly higher in poor controlled diabetes patients compared to good control diabetes patients (P < 0.001), and it was significant throughout the postprandial period.Conclusion: Good glycemic control improves first phase insulin response to meal challenge in diabetes patients.