Effect of lowering postprandial hyperglycemia on insulin secretion in older people with impaired glucose tolerance

被引:18
作者
Chang, AM
Smith, MJ
Bloem, CJ
Galecki, AT
Halter, JB
机构
[1] Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Inst Gerontol, Ann Arbor, MI 48109 USA
来源
AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM | 2004年 / 287卷 / 05期
关键词
beta-cell function; glucose intolerance; aged humans;
D O I
10.1152/ajpendo.00156.2004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Glucose tolerance declines with age, resulting in a high prevalence of diabetes and impaired glucose tolerance (IGT) in the older population. Hyperglycemia per se can lead to impaired beta-cell function (glucose toxicity). We tested the role of glucose toxicity in age-related beta-cell dysfunction in older people (65+/-8 yr) with IGT treated with the alpha-glucosidase inhibitor acarbose (n=14) or placebo (n=13) for 6 wk in a randomized, double-blind study. Baseline and posttreatment studies included 1) an oral glucose tolerance test (OGTT), 2) 1-h postprandial glucose monitoring, 3) a frequently sampled intravenous glucose tolerance test (insulin sensitivity, or S-I), and 4) glucose ramp clamp (insulin secretion rates, or ISR), in which a variable glucose infusion increases plasma glucose from 5 to 10 mM. The treatment groups had similar baseline body mass index; fasting, 2-h OGTT, and 1-h postprandial glucose levels; and S-I. In these carefully matched older people with IGT, both fasting (5.7+/-0.2 vs. 6.3+/-0.2 mM, P=0.002) and 1-h postprandial glucose levels (6.9+/-0.3 vs. 8.2+/-0.4 mM, P=0.02) were significantly lower in the acarbose than in the placebo group. Despite this reduction of chronic hyperglycemia in the acarbose vs. placebo group, measures of insulin secretion (ISR area under the curve: 728+/-55 vs. 835+/-81 pmol/kg, P=0.9) and acute insulin response to intravenous glucose (329+/-67 vs. 301+/-54 pM, P=0.4) remained unchanged and impaired. Thus short-term improvement of chronic hyperglycemia does not reverse beta-cell dysfunction in older people with IGT.
引用
收藏
页码:E906 / E911
页数:6
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