Aims: The hepatic insulin clearance (HIC) is an important pathophysiology of type 2 diabetes mellitus (T2DM). Some studies reported that HIC was decreased in the patients with T2DM. However, a basic research reported that hyperglycemia enhances HIC, and it is not well-known whether poorly controlled diabetes increases HIC in the patients with T2DM. We investigated whether HIC was increased in the patients with poorly controlled diabetes, and we also evaluated whether HIC associated with insulin resistance.
Methods: We performed meal tolerance test and hyperinsulinemic-euglycemic clamp for 23 patients with type 2 diabetes (mean HbA1c 7.5%). We calculated the postprandial C-peptide AUC/insulin AUC ratio as HIC.
Result: The HIC significantly correlated with HbA1c (R=0.60, P<0.005). In the patients with high HIC above the median, the mean HbA1c was significantly higher than that of low HIC below the median (7.95% vs. 6.99%, P<0.01). The HIC was not correlated with insulin resistance as evaluated by the glucose clamp method (R=0.29, P=0.16).
Conclusion: These results suggested that hepatic insulin clearance was increased in the patients with poorly controlled T2DM, especially in the patients with HbA1c>8%.
T. Okura: None. M. Anno: None. Y. Ito: None.