We wanted to investigate the changes in beta cell function and insulin sensitivity during long-term CSII therapy in patients with type 2 diabetes (T2D) up to for 3 years. We discontinued oral antidiabetic drugs and applied CSII therapy to T2D patients (number, 110 with 64% of male; age, 59.9 ± 9.1 years; duration, 12.0 ± 9.2 years; HbA1c 8.9 ± 2.0%; BMI 23.5 ± 2.5 kg/m2). Blood samplings were performed yearly for 3 years at overnight fasting and 120 minutes after ingestion of a standard mixed meal (500 kcal). Serum C-peptide, glucose, and HbA1c were measured, and Matsuda Index (MI) were calculated. The patients were grouped into high MI (insulin sensitive group) and low MI (insulin resistant group) groups by the mean value of baseline MI. Mean HbA1c decreased significantly from 8.9% to 6.5% and there was no difference in glycemic control between the two groups. In insulin sensitive group, mean serum C-peptide increased significantly during CSII therapy. In contrast, mean serum C-peptide did not change but mean MI increased significantly in insulin resistant group (Fig. 1).
In conclusion, by the physiological delivery of insulin using insulin pumps, the two main pathophysiologies of T2D, either insulin deficiency or insulin resistance, seemed to be corrected, respectively.
S. Choi: Stock/Shareholder; Self; SOOIL Developments Co., Ltd.. E. Hong: None. Y. Noh: None.