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- Title
Daytime Variation in Postprandial Glucose and Pancreatic Beta-Cell Response in Persons with Type 2 Diabetes on Diet and Oral Hypoglycaemic Agents, with Varying Degrees of Glycaemic Control.
- Authors
Peter, Rajesh; Luzio, Stephen D.; Dunseath, Gareth; Chudleigh, Richard; Owens, David R.
- Abstract
It has been previously suggested that glycaemic excursions in subjects with type 2 diabetes vary during the day, following identical meals. The aim of this study was to investigate, in subjects with different levels of HbA[sub 1c] differences in B-cell secretory patterns during the day in response to 3 identical meals. Non- insulin treated persons with type 2 diabetes (n=49) were recruited into this study. All were on a stable dose of gliclazide for at least 3 months, with or without metformin. All subjects had 3 consecutive standard 500kcal meal tolerance tests (MTT) at 08.00, 12.00 and 16.00hrs following an overnight fast. Plasma glucose, insulin, C-peptide, total and intact proinsulin were measured over the 12 hour study period. Subjects were divided into groups according to their HbA[sub 1c] (Gp1 <7.3% [n=l 8]; Gp2 7.3-8.0% [n=17]; Gp3 >8.0% [n=14]). Excursions were determined by area under the curve above baseline level (δAUC), calculated by the trapezoidal rule. In all groups, the largest glucose excursion of the day was following the morning meal, with the middle meal having the smallest excursion (Gp1: 11.26±1.23, 4.70±0.97, 7.86±-0.91; Gp2: 14.24±1.02, 3.12±1.09, 7.05±0.85; Gp3:13.48±1.90, 2.93±0.76, 6.72±0.85mmol.h/L; meals 1, 2 and 3, respectively). In all three groups, plasma insulin, C-peptide, total and intact proinsulin were significantly different between meals 1 and 2 (p<0.05) and meals 1 and 3 (p<0.05), with the greatest excursion observed during meal 1. Plasma insulin excursions were significantly different between meals 2 and 3 in Gp1 (p<0.05), however no significant differences were observed in Gp2 and Gp3. There were no significant differences in C-peptide, total or intact proinsulin responses between meals 2 and 3. In these non-insulin treated persons with type 2 diabetes, the greatest glucose excursion was following the morning meal, irrespective of glycaemic control. In the better controlled subjects (HbA[sub 1e] <7.3%), the glucose stimulated insulin response was relatively maintained throughout the day, however, as glycaemic control deteriorated beta-cell secretion became insensitive to glucose stimulation particularly following the evening meal.
- Subjects
GLUCOSE; PANCREATIC beta cells; TYPE 2 diabetes; DIET; HYPOGLYCEMIC agents; BLOOD sugar
- Publication
Diabetes, 2007, Vol 56, pA682
- ISSN
0012-1797
- Publication type
Article