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Åke Lernmark

Principal investigator

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Effects of duration of type 2 diabetes mellitus on insulin secretion.

Author

  • F Zangeneh
  • P S Arora
  • P J Dyck
  • L Bekris
  • Åke Lernmark
  • S J Achenbach
  • A L Oberg
  • R A Rizza

Summary, in English

Objective: To gain insight into the effects of duration of type 2 diabetes on insulin secretion in patients with type 2 diabetes mellitus.



Methods: C-peptide concentrations were measured every 2 years before and after intravenous injection of 1 mg of glucagon in 89 patients with type 2 diabetes (51 men and 38 women) as part of the Rochester Diabetic Neuropathy Study in those subjects who participated in follow-up (median, 12 years; range, 6 to 14).



Results: Although insulin secretion decreased over time (P<0.001) in the group as a whole, both the pattern and the rate of decline in C-peptide concentration differed considerably among the study subjects. Insulin secretion, whether measured as fasting C-peptide, 6-minute C-peptide, or postglucagon increment in C-peptide concentrations, declined with increasing duration of diabetes in approximately half of the patients but either increased or remained essentially constant over time in the other half. The decrease in insulin secretion was not associated with a deterioration in glycemic control because hemoglobin A1c also declined (P<0.005) during the same interval.



Conclusion: We conclude that insulin secretion decreases over time in many patients with type 2 diabetes. Because the rate of decline is variable, the predictive value of any single measurement is limited. These data indicate that although a decrease in insulin secretion over time is characteristic of type 2 diabetes mellitus, it is not inevitable.

Publishing year

2006

Language

English

Pages

388-393

Publication/Series

Endocrine Practice

Volume

12

Issue

4

Document type

Journal article

Publisher

American Association of Clinical Endocrinologists

Topic

  • Endocrinology and Diabetes

Status

Published

ISBN/ISSN/Other

  • ISSN: 1530-891X