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Original Articles

Fasting Plus Prandial Insulin Supplements Improve Insulin Secretory Ability in NIDDM Subjects

  1. Ryuzo Kawamori, MD, PhD,
  2. Kazuo Bando, MD, PhD,
  3. Yoshimitsu Yamasaki, MD, PhD,
  4. Minoru Kubota, MD,
  5. Takao Watarai, MD,
  6. Norimichi Iwama, MD, PhD,
  7. Motoaki Shichiri, MD, PhD and
  8. Takenobu Kamada, MD, PhD
  1. First Department of Medicine, Osaka University Medical School Osaka, Japan
  1. Address correspondence and reprint requests to Ryuzo Kawamori, MD, First Department of Medicine, Osaka University Medical School, 1-1-50 Fukushima, Fukushima-ku, Osaka 553, japan.
Diabetes Care 1989 Nov; 12(10): 680-685. https://doi.org/10.2337/diacare.12.10.680
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Abstract

To examine how insulin secretory ability is modified by strict glycemic control in non-insulin-dependent diabetes mellitus (NIDDM) subjects, basal and/or prandial insulin was supplemented for 4 wk in 24 diabetic subjects who were secondary failures to sulfonylurea treatment. One intermediate-acting insulin injection a day (n = 7) failed to suppress the rise in plasma C-peptide after meals and did not improve plasma C-peptide responses during a posttreatment oral glucose challenge. Continuous subcutaneous insulin infusion with a premeal bolus (n = 8) suppressed both fasting and meal-related rises in C-peptide and improved C-peptide response during the posttreatment oral glucose challenge. Daily insulin requirements during the 4 wk of treatment were reduced significantly by 52%. A short-acting insulin injection before each meal (n = 9) without basal supplementation suppressed the prandial rise in C-peptide and was associated with a significant reduction in daily insulin requirements during 4 wk of treatment by 28%. Diabetic subjects whose fasting and prandial hyperglycemia were <140 and <200 mg/dl, respectively, showed a significantly higher C-peptide response during oral glucose challenge after treatment than those whose insulin treatment only normalized (<200 mg/dl) prandial but not basal hyperglycemia (>140 mg/dl). These results suggest that a short-term period of meal-related insulin treatment (which normalized prandial glycemia) increases residual β-cell function in NIDDM subjects who failed long-term sulfonylurea administration. A basal insulin supplement alone was not effective. The effectiveness of a prandial insulin supplement may have been further improved by a combined basal and meal-related treatment program

  • Copyright © 1989 by the American Diabetes Association

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November 1989, 12(10)
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Fasting Plus Prandial Insulin Supplements Improve Insulin Secretory Ability in NIDDM Subjects
Ryuzo Kawamori, Kazuo Bando, Yoshimitsu Yamasaki, Minoru Kubota, Takao Watarai, Norimichi Iwama, Motoaki Shichiri, Takenobu Kamada
Diabetes Care Nov 1989, 12 (10) 680-685; DOI: 10.2337/diacare.12.10.680

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Fasting Plus Prandial Insulin Supplements Improve Insulin Secretory Ability in NIDDM Subjects
Ryuzo Kawamori, Kazuo Bando, Yoshimitsu Yamasaki, Minoru Kubota, Takao Watarai, Norimichi Iwama, Motoaki Shichiri, Takenobu Kamada
Diabetes Care Nov 1989, 12 (10) 680-685; DOI: 10.2337/diacare.12.10.680
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