Beta cell function and response to treatment in Nigerians with Type 2 diabetes mellitus

Oli, Johnnie; Adeyemo, Adebowale; Okafor, Godfrey; Ofoegbu, Esther N; Onyenekwe, Belonwu M.; Chukwuka, Chinwe; Chen, G.; Chen, Y.; Doumatey, Ayo P.; Aje, Temilolu; Rotimi, Charles N.

doi:10.1016/j.diabres.2004.12.006

Cited by 7 publications

(15 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent study in which we assessed β-cell function in Nigerians with T2DM using glucagon stimulated C-peptide, we found that 51% had a value of ≤1.8 ng/mL, a level often regarded as severe enough for potential insulin requirement. 31 Therefore, reduced IS seems to be a feature of established T2DM in Nigerians. In this study, duration of diabetes negatively correlated and predicted IS, which is similar to the generally accepted view that β-cell function declines with duration of diabetes in T2DM.…”

Section: Discussionmentioning

confidence: 99%

Basal Insulin Resistance and Secretion in Nigerians With Type 2 Diabetes Mellitus

Oli

Adeyemo

Okafor

et al. 2009

Metabolic Syndrome and Related Disorders

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Basal Insulin Resistance and Secretion in Nigerians With Type 2 Diabetes Mellitus

Oli

Adeyemo

Okafor

et al. 2009

Metabolic Syndrome and Related Disorders

Self Cite

View full text Add to dashboard Cite

show abstract

“…The combination of insulin deficiency and increased counter- regulatory hormones also lead to release of free fatty acids into the circulation from adipose tissue (lipolysis) and to unrestrained hepatic fatty acid oxidation to ketone bodies (β-hydroxybutyrate and acetoacetate), with resultant ketonemia and metabolic acidosis. In HHS however, while the plasma insulin concentration may be inadequate to facilitate glucose utilization it is adequate to prevent lipolysis and subsequent ketogenesis [ 32 ]. Both DKA and HHS are associated with glycosuria, leading to osmotic diuresis with loss of water, sodium, potassium, and other electrolytes [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

“…The two most common precipitating factors in the development of DKA or HHS are inadequate or inappropriate insulin therapy and infection. Infections are the leading cause of HHS (57.1 percent); the most common infection is pneumonia, often gram negative, followed by urinary tract infection and sepsis [ 31 , 32 ]. Other precipitating factors include pancreatitis, myocardial infarction, pulmonary embolism, cerebrovascular accident, and drugs [ 36 , 46 ] such as corticosteroids, thiazides, and sympathomimetic agents (e.g., dobutamine and terbutaline) [ 47 ] and second-generation antipsychotics agents [ 39 ].…”

Section: Introductionmentioning

confidence: 99%

Serum C-peptide assay of patients with hyperglycemic emergencies at the Lagos State University Teaching Hospital (LASUTH), Ikeja

Akinlade¹,

Ogbera²,

Fasanmade³

et al. 2014

Int Arch Med

View full text Add to dashboard Cite

IntroductionHE are common acute complications of diabetes mellitus (DM) and include diabetic ketoacidosis (DKA), normo-osmolar hyperglycemic state (NHS) and hyperosmolar hyperglycemic state (HHS). They contribute a lot to the mortality and morbidity of DM. The clinical features include dehydration, hyperglycemia, altered mental status and ketosis. The basic mechanism of HE is a reduction in the net effective action of circulating insulin, resulting in hyperglycemia and ketonemia (in DKA) causing osmotic diuresis and electrolytes loss. Infection is a common precipitating factor.Measurement of serum C-peptide provides an accurate assessment of residual β-cell function and is a marker of insulin secretion in DM patients.Aim and objectivesTo assess the level of pancreatic beta cell function in HE patients, using the serum C-peptide.MethodologyThe biodata and clinical characteristics of the 99 subjects were collated using a questionnaire. All subjects had their serum C-peptide, glucose, electrolytes, urea, creatinine levels, urine ketones determined at admission. Results of statistical analysis were expressed as mean ± standard deviation (SD). A p value <0.05 was regarded statistically significant. Correlation between levels of serum C-peptide and admission blood glucose levels and the duration of DM respectively was done.ResultsThe mean age of the subjects was 51 (SD ± 16) years and comparable in both sexes. Mean duration of DM was 6.3 (SD ± 7.1) years, with 35% newly diagnosed at admission.The types of HE in this study are: DKA (24.7%), NHS (36.1%), and HHS (39.2%). Mean blood glucose in this study was 685 mg/dL, significantly highest in HHS and lowest in NHS. Mean serum C-peptide level was 1.6 ng/dL. It was 0.9 ng/dL in subjects with DKA and NHS while 2.7 ng/dL in HHS (p>0.05).Main precipitating factors were poor drug compliance, new-onset of DM and infection.ConclusionMost (70%) of subjects had poor pancreatic beta cell function, this may be a contributory factor to developing HE. Most subjects with high C-peptide levels had HHS.Electronic supplementary materialThe online version of this article (doi:10.1186/1755-7682-7-50) contains supplementary material, which is available to authorized users.

show abstract

“…Other studies on beta cell function done in this environment have been with the use of oral glucose [9], or glucagon stimulation [11]. …”

Section: Introductionmentioning

confidence: 99%

Beta cell response to a mixed meal in nigerian patients with type 2 diabetes

2012

View full text Add to dashboard Cite

BackgroundThe pathophysiology of type2 diabetes involves both insulin resistance and poor beta cell function. Studies have been done in several populations to assess the relative importance of these mechanisms in individual patients. In our environment studies to assess beta cell function have been done with glucagon stimulation or an oral glucose tolerance test. This study was done to assess the response of the beta cell to a standardized mixed meal and its relationship with glycaemic control in patients with type2 diabetes.MethodsNinety patients with type 2 diabetes were recruited into the study. Weight, height, body mass index and waist circumference were measured. Blood samples were analysed for fasting plasma glucose (FPG) and fasting C peptide (FCP) and glycated haemoglobin (HbA1c). Patients were given their usual drugs for management of their diabetes and then served with a standard meal calculated to contain 50 g of carbohydrate, made up of 53 % carbohydrate, 17 % of protein and 30 % of lipids, providing 500 kcal. Blood samples 2 hours after the start of the meal were analysed for postprandial glucose (PPG) and postprandial C peptide (PCP). Fasting (M0) and postprandial beta cell responsiveness (M1) were calculated.ResultsThe mean FPG and PPG were 7.51+/− 3.39 mmol/l and 11.02+/−4.03 mmol/l respectively while the mean glycated haemoglobin (HbA1c) was 9.0+/−2.5 %. The mean fasting C peptide was 1.44+/−1.80ug/ml. Many of the patients (56.7 %) had low FCP levels. The mean postprandial C peptide was 4.0+/−2.8 ng/ml. There were significant correlations between M1, HbA1c and PPG (p = 0.015, 0.024, 0.001 respectively) and also between M0, HbA1c, PPG and FPG (p = 0.001, 0.002, 0.001). HbA1c decreased across increasing tertiles of M0 (p < 0.001) and also M1 (p = 0.002). In step-wise linear regression analysis, M0 and M1 significantly predicted HbA1c.ConclusionsMany of the patients had low C peptide levels with poor beta cell response to the meal. The patients had poor glycaemic control and poor beta cell function. Both fasting and postprandial beta cell responsiveness were significant determinants of blood glucose and glycated haemoglobin levels. It is likely that putting these patients on insulin may have led to better glycaemic control in them.

show abstract

Beta cell function and response to treatment in Nigerians with Type 2 diabetes mellitus

Cited by 7 publications

References 26 publications

Basal Insulin Resistance and Secretion in Nigerians With Type 2 Diabetes Mellitus

Basal Insulin Resistance and Secretion in Nigerians With Type 2 Diabetes Mellitus

Serum C-peptide assay of patients with hyperglycemic emergencies at the Lagos State University Teaching Hospital (LASUTH), Ikeja

Beta cell response to a mixed meal in nigerian patients with type 2 diabetes

Contact Info

Product

Resources

About