Association of glycemia with insulin sensitivity and β-cell function in adults with early type 2 diabetes on metformin alone

the GRADE Research Group

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Abstract

Aims: Evaluate the relationship between measures of glycemia with β-cell function and insulin sensitivity in adults with early type 2 diabetes mellitus (T2DM). Methods: This cross-sectional analysis evaluated baseline data from 3108 adults with T2DM <10 years treated with metformin alone enrolled in the Glycemia Reduction Approaches in Diabetes. A Comparative Effectiveness (GRADE) Study. Insulin and C-peptide responses and insulin sensitivity were calculated from 2-h oral glucose tolerance tests. Regression models evaluated the relationships between glycemic measures (HbA1c, fasting and 2-h glucose), measures of β-cell function and insulin sensitivity. Results: Insulin and C-peptide responses were inversely associated with insulin sensitivity. Glycemic measures were inversely associated with insulin and C-peptide responses adjusted for insulin sensitivity. HbA1c demonstrated modest associations with β-cell function (range: r − 0.22 to −0.35). Fasting and 2-h glucose were associated with early insulin and C-peptide responses (range: r − 0.37 to −0.40) as well as late insulin and total insulin and C-peptide responses (range: r − 0.50 to −0.60). Conclusion: Glycemia is strongly associated with β-cell dysfunction in adults with early T2DM treated with metformin alone. Efforts to improve glycemia should focus on interventions aimed at improving β-cell function. This Trial is registered in Clinicaltrials.gov as NCT01794143.

Original languageEnglish (US)
Article number107912
JournalJournal of Diabetes and Its Complications
Volume35
Issue number5
DOIs
StatePublished - May 2021

Keywords

  • Beta-cell function
  • Glucose tolerance
  • Glycemic control
  • Insulin sensitivity
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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