Effect of Insulin Versus Triple Oral Therapy on the Progression of Hepatic Steatosis in Type 2 Diabetes

Ildiko Lingvay, Erin D. Roe, Jonathan Duong, David Leonard, Lidia S. Szczepaniak

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Hyperinsulinemia has been associated with hepatic fat deposition and ensuing insulin resistance. It is unknown if treatment with exogenous insulin in patients with type 2 diabetes, who are most prone to hepatic fat accumulation, would promote the occurrence or worsening of nonalcoholic fatty liver disease. Methods Patients with treatment-naive type 2 diabetes (N = 16) were treated with insulin and metformin for a 3-month lead-in period, then assigned triple oral therapy (metformin, glyburide, and pioglitazone) or continued treatment with insulin and metformin. Hepatic triglyceride content (HTC) - measured by magnetic resonance spectroscopy, serum lipids, glucose, liver function tests, and inflammatory and thrombotic biomarkers were followed for a median of 31 months. Results The 45% decline in HTC during the lead-in period persisted through the follow-up period with no difference between treatment groups at the end of the study (5.26 ± 4.21% in the triple oral therapy vs 7.47 ± 7.40% for insulin/metformin), whereas glycemic control was comparable. Conclusions Improvements in HTC with initial insulin/metformin therapy persisted through the median 31-month follow-up period regardless of the treatment. More importantly, insulin-based treatment did not appear to promote or worsen nonalcoholic fatty liver disease.

Original languageEnglish (US)
Pages (from-to)1059-1063
Number of pages5
JournalJournal of Investigative Medicine
Volume60
Issue number7
DOIs
StatePublished - 2012

Fingerprint

Medical problems
Type 2 Diabetes Mellitus
Insulin
Metformin
Liver
Triglycerides
pioglitazone
Therapeutics
Fats
Magnetic resonance spectroscopy
Biomarkers
Liver Function Tests
Hyperinsulinism
Insulin Resistance
Lipids
Glucose
Magnetic Resonance Spectroscopy
Serum

Keywords

  • hepatic steatosis
  • insulin
  • NAFLD
  • triglyceride
  • type 2 diabetes

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Effect of Insulin Versus Triple Oral Therapy on the Progression of Hepatic Steatosis in Type 2 Diabetes. / Lingvay, Ildiko; Roe, Erin D.; Duong, Jonathan; Leonard, David; Szczepaniak, Lidia S.

In: Journal of Investigative Medicine, Vol. 60, No. 7, 2012, p. 1059-1063.

Research output: Contribution to journalArticle

Lingvay, Ildiko ; Roe, Erin D. ; Duong, Jonathan ; Leonard, David ; Szczepaniak, Lidia S. / Effect of Insulin Versus Triple Oral Therapy on the Progression of Hepatic Steatosis in Type 2 Diabetes. In: Journal of Investigative Medicine. 2012 ; Vol. 60, No. 7. pp. 1059-1063.
@article{5a13cccea47849bcb17cdc5fff2226a0,
title = "Effect of Insulin Versus Triple Oral Therapy on the Progression of Hepatic Steatosis in Type 2 Diabetes",
abstract = "Background Hyperinsulinemia has been associated with hepatic fat deposition and ensuing insulin resistance. It is unknown if treatment with exogenous insulin in patients with type 2 diabetes, who are most prone to hepatic fat accumulation, would promote the occurrence or worsening of nonalcoholic fatty liver disease. Methods Patients with treatment-naive type 2 diabetes (N = 16) were treated with insulin and metformin for a 3-month lead-in period, then assigned triple oral therapy (metformin, glyburide, and pioglitazone) or continued treatment with insulin and metformin. Hepatic triglyceride content (HTC) - measured by magnetic resonance spectroscopy, serum lipids, glucose, liver function tests, and inflammatory and thrombotic biomarkers were followed for a median of 31 months. Results The 45{\%} decline in HTC during the lead-in period persisted through the follow-up period with no difference between treatment groups at the end of the study (5.26 ± 4.21{\%} in the triple oral therapy vs 7.47 ± 7.40{\%} for insulin/metformin), whereas glycemic control was comparable. Conclusions Improvements in HTC with initial insulin/metformin therapy persisted through the median 31-month follow-up period regardless of the treatment. More importantly, insulin-based treatment did not appear to promote or worsen nonalcoholic fatty liver disease.",
keywords = "hepatic steatosis, insulin, NAFLD, triglyceride, type 2 diabetes",
author = "Ildiko Lingvay and Roe, {Erin D.} and Jonathan Duong and David Leonard and Szczepaniak, {Lidia S.}",
year = "2012",
doi = "10.2310/JIM.0b013e3182621c5f",
language = "English (US)",
volume = "60",
pages = "1059--1063",
journal = "Journal of Investigative Medicine",
issn = "1081-5589",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Effect of Insulin Versus Triple Oral Therapy on the Progression of Hepatic Steatosis in Type 2 Diabetes

AU - Lingvay, Ildiko

AU - Roe, Erin D.

AU - Duong, Jonathan

AU - Leonard, David

AU - Szczepaniak, Lidia S.

PY - 2012

Y1 - 2012

N2 - Background Hyperinsulinemia has been associated with hepatic fat deposition and ensuing insulin resistance. It is unknown if treatment with exogenous insulin in patients with type 2 diabetes, who are most prone to hepatic fat accumulation, would promote the occurrence or worsening of nonalcoholic fatty liver disease. Methods Patients with treatment-naive type 2 diabetes (N = 16) were treated with insulin and metformin for a 3-month lead-in period, then assigned triple oral therapy (metformin, glyburide, and pioglitazone) or continued treatment with insulin and metformin. Hepatic triglyceride content (HTC) - measured by magnetic resonance spectroscopy, serum lipids, glucose, liver function tests, and inflammatory and thrombotic biomarkers were followed for a median of 31 months. Results The 45% decline in HTC during the lead-in period persisted through the follow-up period with no difference between treatment groups at the end of the study (5.26 ± 4.21% in the triple oral therapy vs 7.47 ± 7.40% for insulin/metformin), whereas glycemic control was comparable. Conclusions Improvements in HTC with initial insulin/metformin therapy persisted through the median 31-month follow-up period regardless of the treatment. More importantly, insulin-based treatment did not appear to promote or worsen nonalcoholic fatty liver disease.

AB - Background Hyperinsulinemia has been associated with hepatic fat deposition and ensuing insulin resistance. It is unknown if treatment with exogenous insulin in patients with type 2 diabetes, who are most prone to hepatic fat accumulation, would promote the occurrence or worsening of nonalcoholic fatty liver disease. Methods Patients with treatment-naive type 2 diabetes (N = 16) were treated with insulin and metformin for a 3-month lead-in period, then assigned triple oral therapy (metformin, glyburide, and pioglitazone) or continued treatment with insulin and metformin. Hepatic triglyceride content (HTC) - measured by magnetic resonance spectroscopy, serum lipids, glucose, liver function tests, and inflammatory and thrombotic biomarkers were followed for a median of 31 months. Results The 45% decline in HTC during the lead-in period persisted through the follow-up period with no difference between treatment groups at the end of the study (5.26 ± 4.21% in the triple oral therapy vs 7.47 ± 7.40% for insulin/metformin), whereas glycemic control was comparable. Conclusions Improvements in HTC with initial insulin/metformin therapy persisted through the median 31-month follow-up period regardless of the treatment. More importantly, insulin-based treatment did not appear to promote or worsen nonalcoholic fatty liver disease.

KW - hepatic steatosis

KW - insulin

KW - NAFLD

KW - triglyceride

KW - type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=85006136707&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006136707&partnerID=8YFLogxK

U2 - 10.2310/JIM.0b013e3182621c5f

DO - 10.2310/JIM.0b013e3182621c5f

M3 - Article

C2 - 22801247

AN - SCOPUS:85006136707

VL - 60

SP - 1059

EP - 1063

JO - Journal of Investigative Medicine

JF - Journal of Investigative Medicine

SN - 1081-5589

IS - 7

ER -