Deteriorating beta-cell function in type 2 diabetes: a long-term model.

A Bagust; S Beale

doi:10.1093/qjmed/hcg040

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Deteriorating beta-cell function in type 2 diabetes: a long-term model.

A Bagust·S Beale

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Abstract

BACKGROUND: Type 2 diabetes is characterized by insulin resistance and the progressive loss of islet beta-cell function. Although the former is already established at diagnosis and changes little thereafter, beta-cell function continues to decline, leading to secondary failure of anti-hyperglycaemic therapies. AIM: To develop a quantitative model of the process of beta-cell function decay over time, using trial data. DESIGN: Re-analysis of published data. METHODS: The results of the Belfast Diet Study were re-analysed. Assuming patients are diagnosed at different stages in the disease process, time displacement of data was used to obtain a bi-partite spline model describing loss of insulin secretion over a 6-year period. RESULTS: The model was developed combining two phases, in which a long slow gradual loss of beta-cell function leads to a crisis in metabolic regulation, precipitating a much more rapid decay phase. This paradigm was consistent with a previous non-linear model of beta-cell mass regulation. DISCUSSION: This model may have important implications for targeting appropriate therapy to patients in each phase: delaying or avoiding full clinical type 2 diabetes in the first phase; and preventing the development of diabetic complications in the second phase.

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Adolescent Adult Blood Glucose Diabetes Mellitus, Type 2 Humans Insulin Islets of Langerhans Middle Aged Time Factors Journal Article Research Support, Non-U.S. Gov't

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A Bagust, S Beale. 2003. Deteriorating beta-cell function in type 2 diabetes: a long-term model.. https://doi.org/10.1093/qjmed%2Fhcg040

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