Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Diabetes Care 29:1180 2006
DOI: 10.2337/dc05-2336
© 2006 by the American Diabetes Association
This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ai, M.
Right arrow Articles by Shimokado, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ai, M.
Right arrow Articles by Shimokado, K.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Letters: Observations

Favorable Effects of Early Insulin Secretion by Nateglinide on Postprandial Hyperlipidemia in Patients With Type 2 Diabetes

Masumi Ai, MD, PHD1, Akira Tanaka, MD, PHD2, Kyoko Ogita, MD1 and Kentaro Shimokado, MD, PHD1

1 Department of Vascular Medicine and Geriatrics, Tokyo Medical and Dental University, Tokyo, Japan
2 Department of Health and Nutrition, College of Human Environmental Studies, Kanto-gakuin University, Yokohama, Japan

Address correspondence to Masumi Ai, MD, PhD, Department of Vascular Medicine and Geriatrics, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan. E-mail: ai.vasc{at}tmd.ac.jp

Severe postprandial hyperlipidemia is observed in and substantially contributes to the progression of atherosclerosis in type 2 diabetic patients, especially those with insulin resistance and compensatory hyperinsulinemia (1–4). As with postprandial hyperglycemia, increased lipid levels in type 2 diabetic patients peak late, and the magnitude of the increase is greater than that seen in healthy people (2,4). To determine whether early insulin secretion by nateglinide can suppress postprandial hyperlipidemia in type 2 diabetic patients, 20 Japanese patients (10 men and 10 women, [means ± SE] aged 56.4 ± 2.5 years, with BMI and HbA1c 25.6 ± 1.2 kg/m2 and 5.7 ± 0.1%, respectively) with newly diagnosed type 2 diabetes performed a 75-g oral glucose tolerance test and oral fat tolerance test (OFTT) twice. A 90-mg dose of nateglinide was administered immediately before fat loading in one of the two OFTTs. In the OFTT, each subject ingested 17 g fat/m2 surface area (OFTT cream; Jomo Food Industry, Takasaki, Japan) (2). Plasma glucose and serum insulin, triglycerides, and remnant-like particles cholesterol (RLPC) concentrations were determined before and 30 min and 1, 2, and 4 h after fat loading.

When nateglinide was not administered (Nate–), triglycerides and RLPC continued to increase during OFTT, while no significant changes in plasma glucose or insulin were noted. In OFTT with nateglinide administration (Nate+), increases in triglycerides and RLPC after fat loading were significantly lower than in Nate– by ANOVA (P < 0.001). The average increments of triglycerides and RLPC from baseline to 4 h were 1.1 mmol/l and 0.31 mmol/l in Nate– and 0.46 mmol/l (–58%, P < 0.01) and 0.05 mmol/l (–84%, P < 0.01) in Nate+, respectively. Plasma glucose levels in Nate+ were gradually decreased by 1.6 mmol/l on average after 2 h. Insulin levels in Nate+ peaked after 30 min and then decreased to below baseline level by 4 h. Furthermore, in Nate–, the regarding rates of increase for triglycerides and RLPC during OFTT had significant correlations with {Sigma}insulin during the oral glucose tolerance test (r = 0.63 and 0.72, respectively), which is a surrogate measure for insulin resistance, while in Nate+, there were no significant correlations among them.

Early insulin secretion following nateglinide administration was thus proved to inhibit postprandial hyperlipidemia in type 2 diabetic patients. Improvements in insulin resistance over a short period of time seem to exert substantial influence on lipid parameters. Insulin secretion patterns appear to play a major role in postprandial hyperlipidemia as well as hyperglycemia.

Footnotes

K.S. has received grant/research support from Yamanouchi Pharma.

References

  1. Zilversmit DB: Atherogenesis: a postprandial phenomenon. Circulation60 :473 –485,1979[Abstract/Free Full Text]
  2. Ai M, Tanaka A, Ogita K, Sekine M, Numano F, Reaven GM: Relationship between plasma insulin concentration and plasma remnant lipoprotein response to an oral fat load in patients with type 2 diabetes. J Am Coll Cardiol38 :1628 –1632,2001[Abstract/Free Full Text]
  3. Ai M, Tanaka A, Ogita K, Sekine M, Numano F, Reaven GM: Relationship between plasma insulin and remnant lipoprotein concentrations in patients with impaired glucose tolerance. J Clin Endocrinol Metab85 :3557 –3560,2000[Abstract/Free Full Text]
  4. Uchino H, Niwa M, Shimizu T, Nishiyama K, Kawamori R: Impairment of early insulin response after glucose load, rather than insulin resistance, is responsible for postprandial hyperglycemia seen in obese type 2 diabetes: assessment using nateglinide, a new insulin secretagogue. Endocr J47 :639 –941,2000[Medline]

Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ai, M.
Right arrow Articles by Shimokado, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ai, M.
Right arrow Articles by Shimokado, K.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum