Presence and frequency of beta cell (BC) dysfunction (BCD) and insulinresistance (IR) in patients with newly diagnosed type 2 diabetes mellitus(NDT2D) are imperfectly known, because previous studies used small cohortsand/or only surrogate indexes of BC function and IR. We assessedBC function and IR with state-of-art methods in the VNDS. In 712 GADAnegative,drug naïve, consecutive Italian NDT2D patients we assessed: 1.standard parameters; 2. insulin sensitivity (IS) by the euglycaemic insulinclamp); 3. BC function by state-of-art modeling of prolonged (5 hours) OGTTderivedglucose/C-peptide curves. Thresholds for BCD and IR were the25th percentiles of BC function and IS assessed with the same methodsof the VNDS in Italian subjects with normal glucose regulation of the GENFIEV(n=340) and GISIR (n=386) studies, respectively. In the VNDS, 89.8%[95% C.I.: 87.6 - 92.0%] and 87.8% [85.4 - 90.2] patients had BCD and IR,respectively. Patients with only one defect were 19.7% [16.8 - 22.6]. IsolatedBCD and isolated IR were present in 10.9% [8.6 - 13.2] and 8.9% [6.8 - 11.0]patients, respectively. Coexistence of BCD and IR was observed in 78.9%[75.9 - 81.9] of the patients. 1.4% [0.5 - 2.3] of the patients had no detectablealterations in BC function and IS. Patients (19.7%) with only one metabolicdefect had lower BMI, fasting glucose, HbA1c, triglycerides and BC function,and higher HDL-cholesterol and IS than patients with both BCD and IR(p<0.01 or less after Bonferroni’s correction). In conclusion, in NDT2DM patients:1. at least 75.9% have both BCD and IR; 2. At least 87.6% and 85.4%have BCD and IR, respectively; 3. At least 16.8% have only one defect anda signifi cantly different (milder) metabolic phenotype compared to patientswith both defects. These fi ndings may be relevant to therapeutic strategiescentered on the metabolic phenotype of the patient. ClinicalTrial.gov Identifiers: NCT00879801, NCT01526720.

American Diabetes Association 75th Scientific Meeting - Epidemiology/Genetics Section; Poster 1563-P: Pancreatic Beta-Cell Function, Insulin Sensitivity, and Metabolic Phenotypes in Type 2 Diabetes at the Time of Diagnosis—The Verona Newly Diagnosed Type 2 Diabetes Study (VNDS)

DAURIZ, Marco;Bonadonna, Riccardo;TROMBETTA, Maddalena;BOSELLI, Maria Linda;Santi, Lorenza;BRANGANI, Corinna;PICHIRI, Isabella;BONORA, Enzo
2015-01-01

Abstract

Presence and frequency of beta cell (BC) dysfunction (BCD) and insulinresistance (IR) in patients with newly diagnosed type 2 diabetes mellitus(NDT2D) are imperfectly known, because previous studies used small cohortsand/or only surrogate indexes of BC function and IR. We assessedBC function and IR with state-of-art methods in the VNDS. In 712 GADAnegative,drug naïve, consecutive Italian NDT2D patients we assessed: 1.standard parameters; 2. insulin sensitivity (IS) by the euglycaemic insulinclamp); 3. BC function by state-of-art modeling of prolonged (5 hours) OGTTderivedglucose/C-peptide curves. Thresholds for BCD and IR were the25th percentiles of BC function and IS assessed with the same methodsof the VNDS in Italian subjects with normal glucose regulation of the GENFIEV(n=340) and GISIR (n=386) studies, respectively. In the VNDS, 89.8%[95% C.I.: 87.6 - 92.0%] and 87.8% [85.4 - 90.2] patients had BCD and IR,respectively. Patients with only one defect were 19.7% [16.8 - 22.6]. IsolatedBCD and isolated IR were present in 10.9% [8.6 - 13.2] and 8.9% [6.8 - 11.0]patients, respectively. Coexistence of BCD and IR was observed in 78.9%[75.9 - 81.9] of the patients. 1.4% [0.5 - 2.3] of the patients had no detectablealterations in BC function and IS. Patients (19.7%) with only one metabolicdefect had lower BMI, fasting glucose, HbA1c, triglycerides and BC function,and higher HDL-cholesterol and IS than patients with both BCD and IR(p<0.01 or less after Bonferroni’s correction). In conclusion, in NDT2DM patients:1. at least 75.9% have both BCD and IR; 2. At least 87.6% and 85.4%have BCD and IR, respectively; 3. At least 16.8% have only one defect anda signifi cantly different (milder) metabolic phenotype compared to patientswith both defects. These fi ndings may be relevant to therapeutic strategiescentered on the metabolic phenotype of the patient. ClinicalTrial.gov Identifiers: NCT00879801, NCT01526720.
Newly-diagnosed Type 2 Diabetes, insulin resistance, beta-cell function, oral glucose tolerance test, insulin clamp
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/929136
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