Primary intensive insulin therapy improves islet ?-cell function in type 2 diabetes——A dream or reality? / 中华内分泌代谢杂志

ABSTRACT

Hyperglycaemia attenuates?-cell insulin secretion in response to plasma glucose elevation and reduces insulin-mediated glucose transport. The long-standing severe hyperglycaemia may irreversibly damage?-cells. However, in this regard, there are increasing evidences showing that short-term intensive insulin therapy may significantly improve the response to endogenous insulin by normalizing blood glucose, so as to induce a "honeymoon period" for several years in a considerable number of subjects with newly diagnosed type 2 diabetes. Thus, a question has been raised whether or not insulin therapy should be taken as a part of the strategy of the primary treatment for type 2 diabetes? A number of experts believe that it is an important therapeutic strategy, however, others hold that insulin therapy may yield more cost than benefit and suggest that to halt this cycle of progressive metabolic deterioration by any means may transiently restore metabolic re-compensation in type 2 diabetes. This issue was discussed in the fourth meeting of China Group on Insulin Secretion and in 66th ADA scientific session this year. Here we offer our consideration on this question for your reference.