Data/hora: 10/06/2024 05:38:11

Provedor de dados: | 56
País: | Brazil
Título: | Non-obese adult onset diabetes with oral hypoglycemic agent failure: islet cell autoantibodies or reversible beta cell refractoriness?
Autores: | Sá,J.R.; Silva,R.C.; Nasri,F.; Aguade,L.C.M.; Velloso,L.; Chacra,A.R.; Dib,S.A.
Data: | 2003-10-01
Ano: | 2003
Palavras-chave: | Non-obese diabetes mellitus; Oral hypoglycemic agent failure; Non-insulin-dependent diabete mellitus; Islet cell antibodies; Beta cell function; Insulin sensitivity.
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 &lt; 0.001); median HbA1c was 11.7% before vs 7.2% after insulin treatment (P &lt; 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 &lt; 0.003) and after insulin treatment (Ab+: 0.22 ± 0.13 vs Ab-: 0.44 ± 0.24 nmol/l, P &lt; 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.
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2003001000005
Editor: | Associação Brasileira de Divulgação Científica
Relação: | 10.1590/S0100-879X2003001000005
Formato: | text/html
Fonte: | Brazilian Journal of Medical and Biological Research  v.36 n.10 2003
Fonte: | info:eu-repo/semantics/openAccess