The effect of chronic hyperglycaemia on the islet B-cell responsiveness in newly diagnosed type 2 diabetes

The aim of the present study was to evaluate the effect of chronic hyperglycaemia on the pancreatic B-cell response to stimulation with a standard mixed meal or intravenous glucagon in 7 subjects with newly diagnosed Type 2 diabetes. Stimulation was performed at mean chronic fasting hyperglycaemia of 11.8 +/- 0.7 (SEM) mmol l-1 and at normoglycaemia obtained by an intravenous infusion of regular insulin followed by an insulin wash-out period. The incremental plasma C-peptide area under the curve after stimulation with the meal was similar at normo- and hyperglycaemia. In contrast, prestimulatory plasma C-peptide and the incremental plasma C-peptide area under the curve after stimulation with glucagon were significantly higher at chronic hyperglycaemia than at normoglycaemia (p less than 0.01 and p less than 0.05). In conclusion, chronic hyperglycaemia as seen in newly diagnosed Type 2 diabetes is associated with a complete lack of potentiation of postprandial islet B-cell secretion but a partly preserved potentiation of basal and post-glucagon islet B-cell secretion.