The Beta Cell Function in NIDDM Patients with Secondary Failure:

Summary

Eleven Type 2 (non-insulin-dependent) diabetic patients, islet cell autoantibodies negative, nonobese with secondary failure to oral hypoglycemic agents (OHA) [glyburide (7.5 mg/day) and phenformin (75 mg/day)] and HbA1c 10.2±0.6% were studied. Insulin receptors on circulating monocytes, glucose utilization at supraphysiological insulin concentrations, and plasma C-peptide after i. v. glucagon were evaluated before and after 2 months of combined therapy with OHA and insulin (Ultratard HM Novo).

A significant improvement was demonstrated in HbA1c and glycemia after two months of treatment. Glucose MCR was increased after two months of treatment whilst basal C-peptide was decreased as well as receptor binding to monocytes. After three years of combined therapy, body weight, glycemia and HbA1c did not increase.

After three years the C-peptide basal values were significantly increased with respect to values found after 2 months of therapy.

These results demonstrate that insulin treatment may restore insulin sensitivity in NIDDM patients resistant to OHA treatment and that after three years there is no exhaustion of B-cell function.

Key words

Beta Cell Exhaustion - Oral Hypoglycemic Agents - Insulin Combined Therapy - NIDDM - Secondary Failure