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Exp Clin Endocrinol Diabetes 2023; 131(04): 198-204
DOI: 10.1055/a-2018-4299
Article

Post-Load Insulin Secretion Patterns are Associated with Glycemic Status and Diabetic Complications in Patients with Type 2 Diabetes Mellitus

Jiajia Jiang   *
1   Department of Endocrinology, Jining No. 1 People’s Hospital, Jining, Shandong, China
2   Institute for Chronic Disease Management, Jining No. 1 People’s Hospital, Jining, Shandong, China
,
Yuhao Li   *
3   Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
,
Feng Li
1   Department of Endocrinology, Jining No. 1 People’s Hospital, Jining, Shandong, China
2   Institute for Chronic Disease Management, Jining No. 1 People’s Hospital, Jining, Shandong, China
,
Yan He
3   Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
5   Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
,
Lijuan Song
1   Department of Endocrinology, Jining No. 1 People’s Hospital, Jining, Shandong, China
,
Kun Wang
1   Department of Endocrinology, Jining No. 1 People’s Hospital, Jining, Shandong, China
,
Wenjun You
1   Department of Endocrinology, Jining No. 1 People’s Hospital, Jining, Shandong, China
,
Zhang Xia
3   Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
,
Yingting Zuo
3   Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
,
Xin Su
3   Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
,
Qi Zhai
3   Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
,
Yibo Zhang
3   Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
,
Herbert Gaisano
4   Departments of Medicine and Physiology, University of Toronto, Toronto, Ontario, Canada
,
Deqiang Zheng
3   Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
5   Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
› Author Affiliations Funding This work was supported by the National Natural Science Foundation of China (grant number: 82073648) and the Key Research & Development (R&D) Program of Jining City (2020YXNS037), project ZR2021QH135, supported by Shandong Provincial Natural Science Foundation.
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Abstract

Background To examine whether the different patterns of post-load insulin secretion can identify the heterogeneity of type 2 diabetes mellitus (T2DM).

Methods Six hundred twenty-five inpatients with T2DM at Jining No. 1 People’s Hospital were recruited from January 2019 to October 2021. The 140 g steamed bread meal test (SBMT) was conducted on patients with T2DM, and glucose, insulin, and C-peptide levels were recorded at 0, 60, 120, and 180 min. To avoid the effect of exogenous insulin, patients were categorized into three different classes by latent class trajectory analysis based on the post-load secretion patterns of C-peptide. The difference in short- and long-term glycemic status and prevalence of complications distributed among the three classes were compared by multiple linear regression and multiple logistic regression, respectively.

Results There were significant differences in long-term glycemic status (e. g., HbA1c) and short-term glycemic status (e. g., mean blood glucose, time in range) among the three classes. The difference in short-term glycemic status was similar in terms of the whole day, daytime, and nighttime. The prevalence of severe diabetic retinopathy and atherosclerosis showed a decreasing trend among the three classes.

Conclusions The post-load insulin secretion patterns could well identify the heterogeneity of patients with T2DM in short- and long-term glycemic status and prevalence of complications, providing recommendations for the timely adjustment in treatment regimes of patients with T2DM and promotion of personalized treatment.

Key words

Type 2 diabetes mellitus - post-load insulin secretion - glycemic status - continuous glucose monitoring - diabetic complications

* Jiajia Jiang and Yuhao Li contributed equally.


Supplementary Material



Publication History

Received: 12 September 2022
Received: 21 December 2022

Accepted: 12 January 2023

Article published online:
16 February 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
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