A Glycemic Threshold Above Which the Improvement of β-Cell Function and Glycemia in Response to Insulin Therapy Is Amplified in Early Type 2 Diabetes: The Reversal of Glucotoxicity
Authors' conclusion
The respective improvements in β-cell function and glycemia in response to short-term IIT are amplified in those in whom baseline fasting glucose exceeds a defined threshold, consistent with reversal of glucotoxicity.
Study context
- Population
- Adults with early T2D (mean duration 1.8 ± 1.4 years) receiving 3 weeks of short-term intensive insulin therapy (glargine, lispro)
- Participants
- 108 adults
- Outcome
- Baseline fasting glucose threshold above which post-IIT improvement in β-cell function (Insulin Secretion-Sensitivity Index-2, insulinogenic index/HOMA-IR) and glycemia is amplified
- Follow-up
- 3 weeks
Methodological detailssingle-group, OGTT before and after intensive insulin therapy (IIT), cubic regression modelling
- Single-group
- OGTT before and after IIT
- Cubic regression modelling
Main finding
As reported in the abstract
Relationship of baseline fasting glucose to differential change in β-cell function
Relationship nonlinear; best fit by cubic regression model with inflection (amplification) at fasting glucose
9.3 mmol/L
Further findings
- Inflection point at which nonlinear reductions in fasting and 2-h glucose were both amplified: baseline fasting glucose
- 9.3 mmol/L
Original publication
A Glycemic Threshold Above Which the Improvement of β-Cell Function and Glycemia in Response to Insulin Therapy Is Amplified in Early Type 2 Diabetes: The Reversal of Glucotoxicity. Diabetes Care. Published 20 September 2024. doi:10.
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