Diminished B cell secretory capacity in patients with noninsulin-dependent diabetes mellitus
Open accessAbstract
In order to assess whether patients with noninsulin-dependent diabetes mellitus (NIDDM) possess normal insulin secretory capacity, maximal B cell responsiveness to the potentiating effects of glucose was estimated in eight untreated patients with NIDDM and in eight nondiabetic controls. The acute insulin response to 5 g intravenous arginine was measured at five matched plasma glucose levels that ranged from approximately 100-615 mg/dl. The upper asymptote approached by acute insulin responses (AIRmax) and the plasma glucose concentration at half-maximal responsiveness (PG50) were estimated using nonlinear regression to fit a modification of the Michaelis-Menten equation. In addition, glucagon responses to arginine were measured at these same glucose levels to compare maximal A cell suppression by hyperglycemia in diabetics and controls. Insulin responses to arginine were lower in diabetics than in controls at all matched glucose levels (P less than 0.001 at all levels). In addition, estimated AIRmax was much lower in diabetics than in controls (83 +/- 21 vs. 450 +/- 93 microU/ml, P less than 0.01). In contrast, PG50 was similar in diabetics and controls (234 +/- 28 vs. 197 +/- 20 mg/dl, P equals NS) and insulin responses in both groups approached or attained maxima at a glucose level of approximately 460 mg/dl. Acute glucagon responses to arginine in patients with NIDDM were significantly higher than responses in controls at all glucose levels. In addition, although glucagon responses in control subjects reached a minimum at a glucose level of approximately 460 mg/dl, responses in diabetics declined continuously throughout the glucose range and did not reach a minimum. Thus, A cell sensitivity to changes in glucose level may be diminished in patients with NIDDM. In summary, patients with NIDDM possess markedly decreased maximal insulin responsiveness to the potentiating effects of glucose. Such a defect indicates the presence of a reduced B cell secretory capacity and suggests a marked generalized impairment of B cell function in patients with NIDDM.
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Climbing glucose levels and deteriorating β-cell function are tightly correlated.
“climbing glucose levels and deteriorating β-cell function are tightly correlated ( 49 ).”
From β-Cell Failure in Type 2 Diabetes: Postulated Mechanisms and Prospects for Prevention and Treatment (2014) · cites this paper as [49]
The Discussion reports markedly diminished β-cell insulin secretory capacity in patients with NIDDM and marked fasting hyperglycemia compared with nondiabetic controls. It does not establish a tight correlation between climbing glucose levels and deteriorating β-cell function: the study compared groups and measured responses to experimentally raised glucose, rather than tracking deterioration as glucose rose. (LLM, conf=0.84)
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- Authors
- Ward, W. K., Bolgiano, D. C., McKnight, B., Halter, J. B., & Porte, D.
- Affiliations
- University of Washington (US)
- United States Department of Veterans Affairs (US)
- Venue
- Journal of Clinical Investigation
- Published
- 1984-10-01
- Volume
- 74
- Issue
- 4
- Pages
- 1318-1328
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC425299
- OpenAlex
- W1969480413
- Cited by
- 483
- References
- 37
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 7 · 2023: 6 · 2022: 6 · 2021: 12 · 2020: 13 · 2019: 10 · 2018: 13 · 2017: 8 · 2016: 19 · 2015: 10 · 2014: 19 · 2013: 14 · 2012: 14
- FWCI
- 10.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p30am017047-11, 5r01am012829-17)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, insulin secretion, acute insulin response, arginine stimulation, glucagon response, glucose-stimulated insulin secretion, hyperglycemia, Michaelis-Menten kinetics
- MeSH terms
- Insulin Secretion, Adult, Aging, Arginine, Blood Glucose, Catecholamines, Diabetes Mellitus, Diabetes Mellitus, Type 2, Glucagon, Humans, Insulin, Islets of Langerhans, Male, Middle Aged, Obesity
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