1373-P: Changes in Body Composition Are Associated with Improvement of ß-Cell Function and Insulin Sensitivity after Short-Term Intensive Insulin Therapy in Patients with Newly Diagnosed Type 2 Diabetes

Objective: To investigate the change of muscle strength and body composition during short-term intensive insulin therapy (SIIT) and their association with treatment effects in patients with newly diagnosed type 2 diabetes (T2DM) .

Research Design and Method: Patients with newly diagnosed T2DM were treated with SIIT to normalized blood glucose for at least 1 week. Physical examination including measurement of body diameters (neck circumference, upper arm circumference, waist circumference, hip circumference, thigh circumference, and calf circumference) , muscle strength (grip strength, the five-repetition sit-to-stand test, and the 30-second sit-to-stand test) , and body composition (body fat mass, muscle mass) , were performed. HbA1c and standardized mixed meal challenge tests were performed before and after the therapy.

Results: A total of 53 patients were included. After SIIT, the muscle strength of the lower limbs was significantly enhanced. The average time of the five-repetition sit-to-stand test was shortened from 7.24s±1.58s to 6.15±1.21 (P<0.001) , and the average number of the 30-second sit-to-stand test increased from 24.23±5.56 to 27.69±5.96 (P<0.001) . The HOMA-IR and β-cell function also improved after SIIT. And the baseline thigh circumference was correlated with the change of both HOMA-IR (rs=-0.296 P=0.035) and the insulinogenic index (IGI) (rs=0.373 P=0.006) after SIIT. The fat mass at baseline was also correlated with improvements in both HOMA-IR (rs=-0.368 P=0.021) and the IGI (rs=0.424 P=0.007) after therapy.

Conclusion: The muscle strength of the lower limbs was promoted after SIIT. Improvements in β-cell function and insulin sensitivity after SIIT in newly diagnosed T2DM patients are associated with changes in body composition but there are no relations with muscle strength.