Beta-cell function in type 2 diabetic patients who failed to maintain good glycemic status with a combination of maximum dosages of metformin and sulfonylurea
Tada Kunavisarut, Sutin Sriussadaporn, Raweewan LertwattanarakDivision of Endocrinology and Metabolism, Siriraj Hospital, Mahidol University, Bangkok, ThailandBackground: The aim of this study was to investigate beta-cell function and examine whether sulfonylureas (SUs) are still useful in patients...
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doaj-ec77a9e9541b45dfb6109e2a52ad1ed92020-11-25T02:11:44ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity : Targets and Therapy1178-70072019-05-01Volume 1276177045909Beta-cell function in type 2 diabetic patients who failed to maintain good glycemic status with a combination of maximum dosages of metformin and sulfonylureaKunavisarut TSriussadaporn SLertwattanarak RTada Kunavisarut, Sutin Sriussadaporn, Raweewan LertwattanarakDivision of Endocrinology and Metabolism, Siriraj Hospital, Mahidol University, Bangkok, ThailandBackground: The aim of this study was to investigate beta-cell function and examine whether sulfonylureas (SUs) are still useful in patients with type 2 diabetes (T2DM) who failed to maintain optimal glycemic control with a combination of maximum dosages of metformin and SU.Method: T2DM who had HbA1c >8% during treatment with a combination of maximum dosages of metformin and SU were studied. After enrollment, the patients were assigned to continue maximum dosages of SU and metformin for 2 weeks and then underwent the first oral glucose tolerance test (OGTT), the Max-SU OGTT. After the Max-SU OGTT, SUs were discontinued for 4 weeks and the second OGTT, the Discont-SU OGTT, was performed. After the Discont-SU OGTT, the same SU was restarted at 25% of the maximum dosage (25%Max-SU). After taking 25%Max-SU for 4 weeks, the third OGTT, the 25%Max-SU OGTT, was performed. Metformin at the same dosage was continued throughout the study. Normal OGTT (NGT) subjects, matched for age and body mass index (BMI), were also studied.Results: There were 25 T2DM and 28 NGT subjects. There was no difference in age and BMI between the two groups. The beta-cell function during Max-SU was 0.1, which was higher than 0.06 during Discont-SU (p<0.001) and also higher than 0.09 during 25%Max-SU (p=0.269). The beta-cell function during 25%Max-SU was higher than during Discont-SU (p<0.001). The beta-cell function of the NGT group was 0.34 and higher than during Max-SU (p<0.001). Fasting capillary blood glucose (FCBG) levels during Discont-SU (14.2±3.7 mmol/L) were higher than during 25%Max-SU (12.3±3.4 mmol/L) and during Max-SU (10.3±2.4 mmol/L) (p<0.05). In addition, the FCBG during Discont-SU was higher than that during 25%Max-SU (p<0.05).Conclusion: In T2DM patients who failed to achieve glycemic control with a combination of maximum dosages of metformin and SU, the beta-cell function declined compared to NGT subjects. However, the beta-cells were still responsive to SUs, which play a significant role in glycemic control.Keywords: beta-cell function, sulfonylureas, sulfonylurea failure, type 2 diabetes mellitushttps://www.dovepress.com/beta-cell-function-in-type-2-diabetic-patients-who-failed-to-maintain--peer-reviewed-article-DMSOBeta-cell functionSulfonylureasSulfonylurea failureType 2 diabetes mellitus |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kunavisarut T Sriussadaporn S Lertwattanarak R |
spellingShingle |
Kunavisarut T Sriussadaporn S Lertwattanarak R Beta-cell function in type 2 diabetic patients who failed to maintain good glycemic status with a combination of maximum dosages of metformin and sulfonylurea Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy Beta-cell function Sulfonylureas Sulfonylurea failure Type 2 diabetes mellitus |
author_facet |
Kunavisarut T Sriussadaporn S Lertwattanarak R |
author_sort |
Kunavisarut T |
title |
Beta-cell function in type 2 diabetic patients who failed to maintain good glycemic status with a combination of maximum dosages of metformin and sulfonylurea |
title_short |
Beta-cell function in type 2 diabetic patients who failed to maintain good glycemic status with a combination of maximum dosages of metformin and sulfonylurea |
title_full |
Beta-cell function in type 2 diabetic patients who failed to maintain good glycemic status with a combination of maximum dosages of metformin and sulfonylurea |
title_fullStr |
Beta-cell function in type 2 diabetic patients who failed to maintain good glycemic status with a combination of maximum dosages of metformin and sulfonylurea |
title_full_unstemmed |
Beta-cell function in type 2 diabetic patients who failed to maintain good glycemic status with a combination of maximum dosages of metformin and sulfonylurea |
title_sort |
beta-cell function in type 2 diabetic patients who failed to maintain good glycemic status with a combination of maximum dosages of metformin and sulfonylurea |
publisher |
Dove Medical Press |
series |
Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy |
issn |
1178-7007 |
publishDate |
2019-05-01 |
description |
Tada Kunavisarut, Sutin Sriussadaporn, Raweewan LertwattanarakDivision of Endocrinology and Metabolism, Siriraj Hospital, Mahidol University, Bangkok, ThailandBackground: The aim of this study was to investigate beta-cell function and examine whether sulfonylureas (SUs) are still useful in patients with type 2 diabetes (T2DM) who failed to maintain optimal glycemic control with a combination of maximum dosages of metformin and SU.Method: T2DM who had HbA1c >8% during treatment with a combination of maximum dosages of metformin and SU were studied. After enrollment, the patients were assigned to continue maximum dosages of SU and metformin for 2 weeks and then underwent the first oral glucose tolerance test (OGTT), the Max-SU OGTT. After the Max-SU OGTT, SUs were discontinued for 4 weeks and the second OGTT, the Discont-SU OGTT, was performed. After the Discont-SU OGTT, the same SU was restarted at 25% of the maximum dosage (25%Max-SU). After taking 25%Max-SU for 4 weeks, the third OGTT, the 25%Max-SU OGTT, was performed. Metformin at the same dosage was continued throughout the study. Normal OGTT (NGT) subjects, matched for age and body mass index (BMI), were also studied.Results: There were 25 T2DM and 28 NGT subjects. There was no difference in age and BMI between the two groups. The beta-cell function during Max-SU was 0.1, which was higher than 0.06 during Discont-SU (p<0.001) and also higher than 0.09 during 25%Max-SU (p=0.269). The beta-cell function during 25%Max-SU was higher than during Discont-SU (p<0.001). The beta-cell function of the NGT group was 0.34 and higher than during Max-SU (p<0.001). Fasting capillary blood glucose (FCBG) levels during Discont-SU (14.2±3.7 mmol/L) were higher than during 25%Max-SU (12.3±3.4 mmol/L) and during Max-SU (10.3±2.4 mmol/L) (p<0.05). In addition, the FCBG during Discont-SU was higher than that during 25%Max-SU (p<0.05).Conclusion: In T2DM patients who failed to achieve glycemic control with a combination of maximum dosages of metformin and SU, the beta-cell function declined compared to NGT subjects. However, the beta-cells were still responsive to SUs, which play a significant role in glycemic control.Keywords: beta-cell function, sulfonylureas, sulfonylurea failure, type 2 diabetes mellitus |
topic |
Beta-cell function Sulfonylureas Sulfonylurea failure Type 2 diabetes mellitus |
url |
https://www.dovepress.com/beta-cell-function-in-type-2-diabetic-patients-who-failed-to-maintain--peer-reviewed-article-DMSO |
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