ABSTRACT
ObjectiveTo investigate the role played by acute glucagon response in the short-term intensive insulin therapy induced long-term remission of newly-diagnosed type 2 diabetes.MethodsTen newly-diagnosed type 2 diabetic patients( 7 males,3 females) received intensive continuous subcutaneous insulin infusion( CSII )therapy for 2 weeks.Intravenous glucose tolerance test (IVGTT) and hyperinsulinemia euglycemia clamp test were performed before and after CSII.Glucose infusion rate ( GIR ),acute insulin response ( AIR ) and acute glucagon response (AGR) were assessed.Long-term remission was defined as good glycaemic control without any hypoglycaemic agent (fasting plasma glucose ＜ 7.0 mmol/L 及 2 h postprandial glucose ＜ 10 mmol/L) one year after CSII.Relationship between AGR and long-term remission were analyzed by one way ANOVA and Spearman correlation analysis.Results ( 1 ) Five of the ten patients achieved long-term remission in this study.GIR and AIR in the remission group were increased significantly after CSII compared with those before CSII [ GIR ( 5.39 ± 1.76 vs 2.02 ± 0.83 )mg · kg-1 ·min-1,AIR ( mean 54.1 vs mean 3.39 ) mU · L-1 · min,P＜0.01 respectively ],however both of them were not associated with the remission.(2) AGR in the remission group was significantly higher than that in the non-remission group before CSII ( 5.10±0.60 vs 2.85 ± 1.86,P＜0.05 ) and was decreased significantly after CSII.The mean of AGR after CSII was apparently lower in the remission group than that in non-remission group (0 vs 3.04±2.00,P＜0.01 ).(3)Spearman analysis showed that AGR before CSII and its range of reduction after CSII were correlated with remission ( r for both were 0.731,P=0.016).ConclusionHigher level of AGR before CSII and greater reduction after CSII in the subjects with newly-diagnosed type 2 diabetes were significantly associated with long-term remission,suggesting that pancreatic α cells may play a unique role in the induction of remission of type 2 diabetes.
ABSTRACT
PURPOSE: Bronchial hyperresponsiveness(BHR) in asthma is thought to be a consequence of underlying airway inflammation. But the mechanism responsible for persistent BHR in adolescents with long-term asthma remission is poorly understood. The aim of this study was to examine whether BHR in adolescents with asthma remission is associated with peripheral blood eosinophilia and/or increased serum levels of eosinophil cationic protein(ECP). METHODS: We studied 35 adolescents with long-term asthma remission(neither symptoms nor medication during the previous two years) who have persistent BHR(remission group) and 35 adolescents with symptomatic asthma(symptomatic group) who were matched for methacholine provocative concentration producing a 20% fall in FEV1(PC20) with subjects in the remission group. The peripheral blood eosinophil counts and serum ECP concentrations were compared between these two groups. Correlations between PC20 and peripheral blood eosinophil counts or serum ECP concentrations were assessed in these two groups. RESULTS: Peripheral blood eosinophil counts and serum ECP concentrations were significantly lower in the remission group than in the symptomatic group(273+/-108 vs. 365+/-178/microliter; 16.3+/-9.4 vs. 26.5+/-15.1 microgram/L, both, P<0.05). PC20 was correlated with peripheral blood eosinophil counts and serum ECP concentrations in the symptomatic group(r=-0.385, P=0.022; r=-0.439, P=0.008), but not in the remission group(r=-0.292, P=0.089; r=-0.243, P=0.159). CONCLUSION: BHR in adolescents with long-term asthma remission is not associated with peripheral blood eosinophilia or an increase in serum ECP concentration, which suggests that BHR in this clinical setting may not be attributed to airway eosinophilic inflammation. Further studies including direct assessment of airway inflammation are needed to confirm this conclusion.
Subject(s)
Adolescent , Humans , Asthma , Eosinophil Cationic Protein , Eosinophilia , Eosinophils , Inflammation , Methacholine ChlorideABSTRACT
Objective To investigate the predictors of long-term remission of type 2 diabetes induced by short-term intensive insulin treatment.Methods Fifty-four cases of diabetes mellitus with the duration of illness less than 5 years received an intensive insulin treatment for 2 weeks.The standard meal test and intravenous glucose tolerance test were performed at the baseline and 24 h after treatment completion respectively.Long-term remission meant that the diabetic patients should maintain the target glyeaemic control without any hypoglyeaemie agent within one year.Results The remission rate was 57.4% (31/54) overall,and even reached to 80.6% (29/36) in patients with the duration of illness less than 6 months,whereas,the remission rate was only 11.1% (2/18) in those with the duration of illness more than 12 months.In another view,the remission rate was significantly higher in the patients with fasting plasma glucose (FPG) level of less than 7 mmol/L (78.8%,26/ 33) 24 h after intensive treatment than those with FPG level of more than 7 mmol/L (23.8%,5/21,P