Short‐term recovery of insulin secretion in response to a meal is associated with future glycemic control in type 2 diabetes patients

Abstract

Abstract Aims/Introduction Endogenous insulin secretion could be recovered by improving hyperglycemia in patients with type 2 diabetes. This study aimed to investigate the association between short‐term recovery of insulin secretion during hospitalization and clinical background or future glycemic control in patients with type 2 diabetes. Materials and Methods A total of 127 patients with type 2 diabetes were included. The recovery of endogenous insulin secretion was determined using the following indices: index A: fasting C‐peptide index (CPI) at discharge – fasting CPI on admission; index B: postprandial CPI at discharge – postprandial CPI on admission; and index C: Δ C‐peptide immunoreactivity (CPR) (postprandial CPR − fasting CPR) at discharge – ΔCPR on admission. We examined the associations of each index with clinical background and future glycemic control measured by glycosylated hemoglobin and continuous glucose monitoring. Results Using index A and B, the age was significantly younger, whereas BMI and visceral fat area were significantly higher in the high‐recovery group than in the low‐recovery group. Changes in glycosylated hemoglobin levels were significantly greater at 6 and 12 months in the high‐recovery group in the analysis of index C. The receiver operating characteristic curve analysis identified the index B and index C as indicators to predict glycosylated hemoglobin <7.0% at 6 months after discharge. Furthermore, index C was positively correlated with the time in the target glucose range, and inversely correlated with the standard deviation of glucose at 3 and 12 months after discharge. Conclusions Short‐term recovery of insulin secretion in response to a meal during hospitalization, evaluated with the index‐C, might predict future glycemic control.

Keywords

• C‐peptide index
• Insulin secretion
• Type 2 diabetes