Browse by author
Lookup NU author(s): Dr Sviatlana Zhyzhneuskaya, Dr Ahmad Al-Mrabeh, Dr Carl Peters, Ali/Alison Barnes, Dr Benjamin Aribisala, Dr Kieren HollingsworthORCiD, Dr Naweed Sattar, Professor Roy Taylor
This is the authors' accepted manuscript of an article that has been published in its final definitive form by American Diabetes Association, 2020.
For re-use rights please refer to the publisher's terms and conditions.
Aim: To assess functional beta cell capacity in type 2 diabetes during 2 years of remission induced by dietary weight loss. Methods: A Stepped Insulin Secretion Test with Arginine (SISTA) was used to quantify functional beta cell capacity by hyperglycemia and arginine stimulation. 39/57 subjects initially achieved remission (HbA1c<6.5% (<48mmol/mol) and FPG <7 mmol/l on no antidiabetic drug therapy) with 16.4±7.7 kg weight loss, and were followed up with supportive advice on avoidance of weight regain. At 2 years, 20 subjects remained in remission in the study. A Non-Diabetic Control (NDC) group, matched for age/sex/weight after weight loss with the intervention group, was studied once. Results: During remission, median [IQ range] maximal rate of insulin secretion increased from 581 [480-811] at baseline to 736 [542-998] at 5 months, 942 [565-1240] at 12 months (p=0.028 from baseline), and 936 [635-1435] pmol/min/m2 at 24 months (p=0.023 from baseline; n=20/39 of those initially in remission). This was comparable to NDC (1016 [857- 1507] pmol/min/m2 ) by 12 (p=0.064) and 24 months (p=0.244). Median first phase insulin response increased from baseline to 5 months (42 [4-67] to 107 [59-163] pmol/min/m2 ; p<0.0001), then remained stable at 12 and 24 months (110 [59-201] and 125 [65-166] pmol/min/m2 respectively; p<0.0001 vs. baseline) but lower than that of the NDC group (250 [226-429] pmol/min/m2 ; p<0.0001). Conclusion: A gradual increase in assessed functional beta cell capacity occurred after weight loss, becoming similar to Non-Diabetic Controls by 12 months. This was unchanged at 2 years with continuing remission of type 2 diabetes.
Author(s): Zhyzhneuskaya SV, Al-Mrabeh A, Peters C, Barnes AC, Aribisala B, Hollingsworth KG, McConnachie A, Sattar N, Lean MEJ, Taylor R
Publication type: Article
Publication status: Published
Journal: Diabetes Care
Year: 2020
Volume: 43
Issue: 4
Pages: 813-820
Print publication date: 01/04/2020
Online publication date: 14/02/2019
Acceptance date: 29/12/2019
Date deposited: 11/02/2020
ISSN (print): 0149-5992
ISSN (electronic): 1935-5548
Publisher: American Diabetes Association
URL: https://doi.org/10.2337/dc19-0371
DOI: 10.2337/dc19-0371
Altmetrics provided by Altmetric
