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Cited by 483Pancreatic function and diabetesDiabetes and associated disordersDiabetes Treatment and Management

The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.

Diminished B cell secretory capacity in patients with noninsulin-dependent diabetes mellitus

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Ward, W K, Bolgiano, D C, McKnight, B, Halter, J B, Porte, D·1984·Journal of Clinical Investigation
DOI 10.1172/jci111542PMC PMC425299
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Abstract

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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Metadata

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
Publisher
American Society for Clinical Investigation
Published
1984-10-01
Volume
74
Issue
4
Pages
1318-1328
ISSN
0021-9738 (ISSN-L)
DOI
10.1172/jci111542
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
Locations
  • Journal of Clinical Investigation (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institutes of Health (5p30am017047-11, 5r01am012829-17)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › 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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