PMID- 24215809
OWN - NLM
STAT- MEDLINE
DCOM- 20140902
LR  - 20220408
IS  - 1756-0500 (Electronic)
IS  - 1756-0500 (Linking)
VI  - 6
DP  - 2013 Nov 11
TI  - The proinsulin/insulin (PI/I) ratio is reduced by postprandial targeting therapy 
      in type 2 diabetes mellitus: a small-scale clinical study.
PG  - 453
LID - 10.1186/1756-0500-6-453 [doi]
AB  - BACKGROUND: An elevated PI/I ratio is attributable to increased secretory demand 
      on beta-cells. However, the effect of postprandial targeting therapy on proinsulin 
      level is unknown. We evaluated the metabolic effect of glinide and sulfonylurea 
      (SU) using the meal tolerance test (MTT). METHODS: MTT was applied to previously 
      untreated Type 2 Diabetes Mellitus (T2DM) subjects. Twenty-two participants were 
      given a test meal (450 kcal). Plasma glucose and insulin were measured at 0 
      (fasting), 30, 60, 120, and 180 min. Serum proinsulin and C-peptide 
      immunoreactivity (CPR) were measured at 0 and 120 min. Postprandial profile was 
      assessed at baseline and following 3 months treatment with either mitiglinide or 
      glimepiride. RESULTS: Plasma glucose level at 30, 60, 120, and 180 min was 
      significantly improved by mitiglinide. Whereas, glimepiride showed a significant 
      improve plasma glucose at 0, 180 min. Peak IRI shifted from 120 to 30 min by 
      mitiglinide treatment. The pattern of insulin secretion was not changed by 
      glimepiride treatment. Whereas mitiglinide did not affect the PI/I ratio, 
      glimepiride tended to increase the PI/I ratio. Moreover, although mitiglinide did 
      not affect PI/I ratio as a whole, marked reduction was noted in some patients 
      treated by mitiglinide. PI/I ratio was reduced significantly in the responder 
      group. The responder subgroup exhibited less insulin resistance and higher 
      insulinogenic index at baseline than non-responders. Moreover, the triglyceride 
      level of responders was significantly lower than that of non-responders. 
      CONCLUSIONS: Mitiglinide improved postprandial insulin secretion pattern and 
      thereby suppressed postprandial glucose spike. In T2DM patients with low insulin 
      resistance and low triglyceride, mitiglinide recovered impaired beta-cell function 
      from the viewpoint of the PI/I ratio. TRIAL REGISTRATION UMIN-CTR: UMIN000010467.
FAU - Ohkura, Tsuyoshi
AU  - Ohkura T
AD  - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of 
      Molecular Medicine and Therapeutics, Tottori University Faculty of Medicine, 
      Yonago, Tottori, Japan. ohkura@med.tottori-u.ac.jp.
FAU - Inoue, Kazuoki
AU  - Inoue K
FAU - Fujioka, Youhei
AU  - Fujioka Y
FAU - Nakanishi, Risa
AU  - Nakanishi R
FAU - Shiochi, Hideki
AU  - Shiochi H
FAU - Sumi, Keisuke
AU  - Sumi K
FAU - Yamamoto, Naoya
AU  - Yamamoto N
FAU - Matsuzawa, Kazuhiko
AU  - Matsuzawa K
FAU - Izawa, Shoichiro
AU  - Izawa S
FAU - Ohkura, Hiroko
AU  - Ohkura H
FAU - Kato, Masahiko
AU  - Kato M
FAU - Yamamoto, Kazuhiro
AU  - Yamamoto K
FAU - Taniguchi, Shin-ichi
AU  - Taniguchi S
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131111
PL  - England
TA  - BMC Res Notes
JT  - BMC research notes
JID - 101462768
RN  - 0 (Blood Glucose)
RN  - 0 (C-Peptide)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Isoindoles)
RN  - 0 (Sulfonylurea Compounds)
RN  - 0 (Triglycerides)
RN  - 6KY687524K (glimepiride)
RN  - 9035-68-1 (Proinsulin)
RN  - D86I0XLB13 (mitiglinide)
SB  - IM
MH  - Aged
MH  - Blood Glucose/metabolism
MH  - C-Peptide/blood
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Fasting
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Insulin/*blood
MH  - Isoindoles/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Molecular Targeted Therapy
MH  - Postprandial Period
MH  - Proinsulin/*blood
MH  - Sulfonylurea Compounds/*therapeutic use
MH  - Triglycerides/blood
PMC - PMC3829708
EDAT- 2013/11/13 06:00
MHDA- 2014/09/03 06:00
PMCR- 2013/11/11
CRDT- 2013/11/13 06:00
PHST- 2013/07/03 00:00 [received]
PHST- 2013/11/08 00:00 [accepted]
PHST- 2013/11/13 06:00 [entrez]
PHST- 2013/11/13 06:00 [pubmed]
PHST- 2014/09/03 06:00 [medline]
PHST- 2013/11/11 00:00 [pmc-release]
AID - 1756-0500-6-453 [pii]
AID - 10.1186/1756-0500-6-453 [doi]
PST - epublish
SO  - BMC Res Notes. 2013 Nov 11;6:453. doi: 10.1186/1756-0500-6-453.