The Effect Of β-cell Function And Insulin Resistance In Newly Diagnosed Type 2 Diabetic Patients By Transient Intensive Insulin Pump Treatment

Aims Type 2 diabetes is a slowly progressive disease, in which the gradual deterioration of glucose tolerance is associated with the progressive decrease in β-cell function and increase in insulin resistance. Some studies had found that the short-term intensive insulin pump treatment could lead to long-term good glycemic control without medication in some type 2 diabetic patients, but the mechanism underline it has not been explored. Our objective is to evaluate β-cell function and insulin resistance by observing the variance of the first-phase and second-phase of insulin response to intravenous glucose before and after transient intensive insulin pump treatment or multiple subcutaneous insulin injection treatment in newly diagnosed type 2 diabetic patients.Methods Newly diagnosed type 2 diabetic patients were randomly divided into two groups: (1)continuous subcutaneous insulin infusion (CSâ…¡) (19 patients) (2)multiple subcutaneous insulin injection (MSâ…¡) (15 patients). Patients were admitted to the hospital and treated with CSâ…¡ or MSâ…¡ for 2 weeks. Before and after the treatment, they were carried out the intravenous glucose tolerance test (IVGTT) and oral glucose tolerance test (OGTT). Acute insulin response (AIR), Insulin area under curve (INS_AUC) and Sensitivity of insulin-mediated (S_IM) were calculated to evaluate the variance of the first-phase of insulin secretion, the second-phase of insulin secretion and insulin sensitivity.Results Two weeks after the treatment, AIR were significantly increased, p<0.05, INS_auc were significantly increased, p<0.001, and S_IM were significantly increased, too, p<0.01 before and after the treatment in CSII group. AIR and S_im were no significantly difference, p>0.05, INSauc were significantly increased, p<0.01 before and after the treatment in MSâ…¡ group. Before treatment, patients of two groups were no significantly difference in age, body mass index (BMI), glycosylated hemoglobin A₁c ( HbA₁c), fasting plasma glucose(FPG), 2-h OGTT plasma glucose (PG2h), AIR, INS_Auc and S_IM (all, p>0.05); After treatment, CSâ…¡ group were significantly increased in AIR (p<0.05) and INS_Auc(p<0.01) thanMSI I group, and two groups were no significantly difference in Sim (p>0.05).Conclusions Short-term intensive insulin pump treatment can effectively restore or partly do the first-phase of insulin response to intravenous glucose in newly diagnosed type 2 diabetic patients, however MS 11 is no this effect. CSII and MS 11 can all increase the second-phase of insulin secretion in newly diagnosed type 2 diabetic patients, but CSII is more significantl than MSI I. Short-term CSII can effectively increase insulin sensitivity in newly diagnosed type 2 diabetic patients, however MS 11 is no this effect. The patients newly diagnosed type 2 diabetes may be brought back in time along the natural history of type 2 diabetes to a stage where non-pharmacological therapeutic measures are still long-term good glycemic control by short-term CSII. We suggest that the transient intensive insulin pump treatment might be used as primary approach in the management newly diagnosed type 2 diabetic patients, and more effective.