Beta cell function in long term NIDDM (type 2) patients and its relation to treatment

Area of Science:

• Endocrinology
• Metabolic Diseases
• Diabetes Mellitus Research

Background:

• Non-insulin dependent diabetes mellitus (NIDDM) management often involves oral hypoglycemic agents (OHAs).
• Long-term efficacy of OHAs can be affected by declining pancreatic beta cell function.
• Assessing beta cell reserve is crucial for understanding treatment response and failure in NIDDM.

Purpose of the Study:

• To evaluate pancreatic beta cell function in patients with NIDDM treated with OHAs for over 10 years.
• To determine the relationship between beta cell reserve and response to OHAs.
• To investigate factors contributing to secondary failure of OHAs.

Main Methods:

• Fasting and post-prandial plasma C-peptide levels were measured in 183 NIDDM patients.
• Patients were categorized based on their response to OHAs (Group I: responders, Group II: secondary failure).
• Beta cell reserve was defined as post-prandial C-peptide >= 0.6 pmol/ml.

Main Results:

• 48% of patients exhibited significant beta cell reserve, with 93% responding well to OHAs.
• Among patients with low beta cell reserve, 62% were on OHAs and 38% on insulin.
• Secondary failure to OHAs occurred in 42 patients; 86% of these had low C-peptide, but 14% had significant C-peptide values.
• Beta cell reserve did not correlate with diabetes duration or age at diagnosis.

Conclusions:

• Significant beta cell reserve is associated with a positive response to oral hypoglycemic agents in long-term NIDDM patients.
• Secondary failure to OHAs can occur despite preserved beta cell reserve.
• Beta cell reserve is not influenced by diabetes duration or age at diagnosis in this cohort.