Improved beta cell function, with reduction in secretion of intact and 32/33 split proinsulin, after dietary intervention in subjects with type 2 diabetes mellitus

Diabet Med. 1994 Jan-Feb;11(1):71-8. doi: 10.1111/j.1464-5491.1994.tb00233.x.

Abstract

Diet in Type 2 diabetes often reduces both hyperglycaemia and weight and both these factors may contribute to improvement in beta cell function. Sixty-nine subjects with newly diagnosed Type 2 diabetes had their glucose, insulin, intact and 32/33 split proinsulin measured at diagnosis, and after 16 (12-20) weeks of conventional diet. In the whole group following diet there was reduction in weight (p < 0.0001), Haemoglobin A1 (p < 0.0001), and fasting glucose (p < 0.0001). There was a fall in fasting intact proinsulin (p < 0.03), 32/33 split proinsulin (p < 0.0001), and the percentage of fasting proinsulin to total insulin-like molecules (p < 0.0001). Subjects were separated according to weight loss (group 1 < 0.5 kg, group 2 0.5-4 kg, group 3 > 4 kg). Only subjects in group 3 (mean weight loss 6.2 kg) had a fall in fasting insulin (p < 0.04). The fasting glucose achieved following diet was positively correlated with the initial fasting glucose (r = 0.7) and negatively correlated with the degree of insulin deficiency at diagnosis (with the initial 30 min insulin r = -0.62). The effect of diet on the final concentration of insulin, 32/33 split proinsulin and intact proinsulin was examined using multiple regression. The final insulin concentration was determined by the initial BMI and absolute weight loss, 32/33 split proinsulin concentration by the initial fasting glucose and absolute glucose fall, and intact proinsulin concentration by a combination of both weight loss and glucose reduction.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism
  • Body Mass Index
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / diet therapy
  • Diabetes Mellitus / physiopathology*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diet therapy
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diet, Diabetic*
  • Fasting
  • Female
  • Humans
  • Insulin / blood
  • Islets of Langerhans / metabolism
  • Islets of Langerhans / physiopathology*
  • Male
  • Middle Aged
  • Obesity*
  • Proinsulin / blood
  • Proinsulin / metabolism*
  • Protein Precursors / blood
  • Protein Precursors / metabolism*
  • Time Factors

Substances

  • Blood Glucose
  • Insulin
  • Protein Precursors
  • proinsulin, des(31,32)-
  • Proinsulin