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- Title
Fasting plus prandial insulin supplements improve insulin secretory ability in NIDDM subjects.
- Authors
Kawamori, Ryuzo; Bando, Kazuo; Yamasaki, Yoshimitsu; Kubota, Minoru; Watari, Takao; Iwama, Norimichi; Shichiri, Motoaki; Kamada, Takenobu; Kawamori, R; Bando, K; Yamasaki, Y; Kubota, M; Watarai, T; Iwama, N; Shichiri, M; Kamada, T
- Abstract
To examine how insulin secretory ability is modified by strict glycemic control in non-insulin-dependent diabetes mellitus (NIDDM) subjects, basal and/or prandial insulin was supplemented for 4 wk in 24 diabetic subjects who were secondary failures to sulfonylurea treatment. One intermediate-acting insulin injection a day (n = 7) failed to suppress the rise in plasma C-peptide after meals and did not improve plasma C-peptide responses during a posttreatment oral glucose challenge. Continuous subcutaneous insulin infusion with a premeal bolus (n = 8) suppressed both fasting and meal-related rises in C-peptide and improved C-peptide response during the posttreatment oral glucose challenge. Daily insulin requirements during the 4 wk of treatment were reduced significantly by 52%. A short-acting insulin injection before each meal (n = 9) without basal supplementation suppressed the prandial rise in C-peptide and was associated with a significant reduction in daily insulin requirements during 4 wk of treatment by 28%. Diabetic subjects whose fasting and prandial hyperglycemia were less than 140 and less than 200 mg/dl, respectively, showed a significantly higher C-peptide response during oral glucose challenge after treatment than those whose insulin treatment only normalized (less than 200 mg/dl) prandial but not basal hyperglycemia (greater than 140 mg/dl). These results suggest that a short-term period of meal-related insulin treatment (which normalized prandial glycemia) increases residual beta-cell function in NIDDM subjects who failed long-term sulfonylurea administration. A basal insulin supplement alone was not effective. The effectiveness of a prandial insulin supplement may have been further improved by a combined basal and meal-related treatment program.
- Publication
Diabetes Care, 1989, Vol 12, Issue 10, p680
- ISSN
0149-5992
- Publication type
journal article
- DOI
10.2337/diacare.12.10.680