Non-obese adult onset diabetes with oral hypoglycemic agent failure: islet cell autoantibodies or reversible beta cell refractoriness?

Non-obese adult onset diabetes with oral hypoglycemic agent failure: islet cell autoantibodies or reversible beta cell refractoriness?

Autor Sá, João Roberto Autor UNIFESP Google Scholar
Silva, Reinaldo Correia Autor UNIFESP Google Scholar
Nasri, Fabio Autor UNIFESP Google Scholar
Aguade, Luiz Carlos Muria Autor UNIFESP Google Scholar
Velloso, Lício Augusto Autor UNIFESP Google Scholar
Chacra, Antonio Roberto Autor UNIFESP Google Scholar
Dib, Sergio Atala Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Pancreatic ß cell function and insulin sensitivity, analyzed by the homeostasis model assessment, before and after 24 weeks of insulin therapy were studied and correlated with the presence of autoantibodies against ß cells (islet cell and anti-glutamic acid decarboxylase antibodies), in a group of 18 Brazilian lean adult non-insulin-dependent diabetes mellitus (NIDDM) patients with oral hypoglycemic agent failure (OHAF). Median fasting plasma glucose before and after insulin treatment was 19.1 and 8.5 mmol/l, respectively (P < 0.001); median HbA1c was 11.7% before vs 7.2% after insulin treatment (P < 0.001). Forty-four percent of the patients were positive (Ab+) to at least one autoantibody. Fasting C-peptide levels were lower in Ab+ than Ab- patients, both before (Ab+: 0.16 ± 0.09 vs Ab-: 0.41 ± 0.35 nmol/l, P < 0.003) and after insulin treatment (Ab+: 0.22 ± 0.13 vs Ab-: 0.44 ± 0.24 nmol/l, P < 0.03). Improvement of Hß was seen in Ab- (median before: 7.3 vs after insulin therapy: 33.4%, P = 0.003) but not in Ab+ patients (median before: 6.6 vs after insulin therapy: 20.9%). These results show that the OHAF observed in the 18 NIDDM patients studied was due mainly to two major causes: autoantibodies and ß cell desensitization. Autoantibodies against ß cells could account for 44% of OHAF, but Ab- patients may still present ß cell function recovery, mainly after a period of ß cell rest with insulin therapy. However, the effects of ß cell function recovery on the restoration of the response to oral hypoglycemic agents need to be determined.
Palavra-chave Non-obese diabetes mellitus
Oral hypoglycemic agent failure
Non-insulin-dependent diabete mellitus
Islet cell antibodies
Beta cell function
Insulin sensitivity
Idioma Inglês
Data de publicação 2003-10-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 36, n. 10, p. 1301-1309, 2003.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 1301-1309
Fonte http://dx.doi.org/10.1590/S0100-879X2003001000005
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000185906900006
SciELO S0100-879X2003001000005 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/1883

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