ABSTRACT
Objective To investigate clinical value of arginine stimulation test to estimate the first-phase insulin release of pancreatic isletβ-cell and evaluation indicators of insulin release.Methods Choose inpatients with diabetes in the department of endocrinology,divide into type 1 diabetes mellitus group (T1DM group)12 cases,type 2 diabetes mellitus group a (T2DMa group,duration of no more than 1 year)57 cases and type 2 diabetes mellitus group b (T2DMb group,more than 1 year),82 cases.Theserum levels of blood glucose (PG),insulin (INS)and C-peptide (CP)were determined at fasting 0 mi-nutes and 2,4,6 minutes after arginine stimulation,and process the results statistically.Results After arginine stimulation, three groups of PG and the T1DM group of INS and CP had no obvious change and there were no statistical significance (F=0.150~0.696,P>0.05).In T2DMa group and T2DMb group,the peak level of INS and CP appeared at 2nd minute,and those in T2DMa group were higher than those in T2DMb group and these were statistical significance (F=12.145~40.518,P0.05).In T2DMa and T2DMb groups,those had positive correlation (r=0.768, 0.722,P<0.01).Conclusion Arginine stimulation test can be sensitively estimated the first-phase insulin release of pancre-atic isletβ-cell and that has certain clinical application value.△INS and △CP can be used to evaluating insulin release.
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To investigate the relationship between serum glutamic acid decarboxylase antibody (GAD-Ab)titer and the first-phase insulin release (1PH)in newly-diagnosed type 2 diabetic patients. 1053 newly-diagnosed type 2 diabetic patients were divided into 3 groups, including 71 individuals with GAD-Ab≥1 U/ml (positive group), 171 individuals with GAD-Ab ranging from 0 to 1 U/ml (negative-1 group), and 811 individuals with GAD-Ab=0 (negative-2 group). IPH was evaluated by arginine stimulation test. In the patients of negative-2, negative-1, and positive groups, the respective values of 1 PH were subsequently decreased significantly (P< 0. 01) , and the detection rates of the decreased insulin secretion were 74. 85%, 87. 13%, and 100%, respectively. Stepwise regression analysis indicated that disease duration, GAD-Ab titer, HbA_1C, and body mass index were the major independent contributing factors. The titer of GAD-Ab has an important impact on 1PH defect in type 2 diabetic patient. Detection of GAD-Ab not only provides an evidence for clinical type, but would also be helpful in determining the islet β-cell function.
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Objective To investigate the value of intravenous arginine stimulation test (AST) in evaluating function of pancreatic islet beta cell response in patients of diabetes mellitus. Methods Twentyone patients with type 1 diabetes mellitus (DM1, DM1 group) and 113 patients with type 2 diabetes mellitus (DM2, DM2 group) were recruited in this study. DM2 patients were divided into two sub-groups, DM2a group (duration of no more than 1 year, 58 patients) and DM2b group (more than 1 year, 55 patients). The serum levels of C-peptide (CP) were determined at fasting and 2,3,4,5 minutes after intravenous injection of 5 g arginine. Results In DM1 group, the level of CP after injection of arginine was. similar to the fasting level (P> 0.05 ). In DM2 group, the peak level of CP appeared at 3th minute (CP3) during AST, and was significantly higher than fasting CP level(P < 0.01 ). The level of fasting and arginine-stimulated CP in DM2a group was significantly higher than that in DM2b group, and the level of fasting and arginine-stimulated CP in DM2b group was significantly higher than that in DM1 group. The patients of DM1 group whose level of CP3 < 600 pmol/L all needed insulin injection to control hyperglycemia, and the coincident rate was 100.0%.In DM2 group, there were 91 patients whose CP3 ≥600 pmol/L, among which 85 patients could be well controlled with diet or oral hypoglycemic agents, and the coincidentrate was 93.4%; there were 22 patients whose CP3 < 600 pmol/L, among which 19 patients need insulin injection to control hyperglycemia, and the coincident rate was 86.4%. Conclusions AST is valuable in assessing the function of pancreatic islet beta cell in patients with diabetes mellitus. The level of CP3 ≥600 pmol/L can be considered as a reference in diagnosis and treatment of diabetes mellitus.
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Objective To evaluate the first-phase insulin release and insulin sensitivity in patients with newly-diagnosed type 2 diabetes.Methods A total of 332 patients with newly-diagnosed type 2 diabetes were classified into two groups of normal or abnormal islet function according to arginine stimulation test,and their results were evaluated.Results (1)Body weight,body mass index (BMI),waist circumference,hip circumference,femoral circumference,fasting serum true insulin and triglyceride in normal islet function group were significantly higher than those in abnormal group (all P
ABSTRACT
Objective To evaluate the pathophysiological change of diabetes and its significance in the treatment of newly-diagnosed type 2 diabetic patients.Methods A total of 322 newly-diagnosed type 2 diabetic patients were included in this study and were divided into 2 groups with normal or impaired islet first-phase insulin secretion according to arginine stimulation test.The former group was assigned to repaglinide (Novo Norm), rosiglitazone (Avandia) and mefformin subgroups and the latter one to repaglinide,rosiglitazone and glipizide subgroups randomly.Results (1)Compared with baseline,fasting plasma glucose,2 h postprandial plasma glucose and HbA_(1C) were significantly decreased in all subgroups after 3 and 6 months of treatment (all P