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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Main Authors: Kunavisarut T, Sriussadaporn S, Lertwattanarak R
Format: Article
Language:English
Published: Dove Medical Press 2019-05-01
Series:Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy
Subjects:
Online Access:https://www.dovepress.com/beta-cell-function-in-type-2-diabetic-patients-who-failed-to-maintain--peer-reviewed-article-DMSO
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spelling 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
collection 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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