Meal-induced increases in C-reactive protein, interleukin-6 and tumour necrosis factor α are attenuated by prandial + basal insulin in patients with Type 2 diabetes

Diabet. Med. 28, 1088–1095 (2011) Aim  To determine if a regimen with prandial + basal insulin compared with basal insulin attenuates post‐meal inflammatory and glycative biomarkers in patients with Type 2 diabetes. Methods  This test‐meal sub‐study in the USA is from a previously reported clinical...

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Published in:Diabetic medicine 2011-09, Vol.28 (9), p.1088-1095
Main Authors: Beisswenger, P. J., Brown, W. V., Ceriello, A., Le, N. A., Goldberg, R. B., Cooke, J. P., Robbins, D. C., Sarwat, S., Yuan, H., Jones, C. A., Tan, M. H.
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
C-Reactive Protein - metabolism
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - metabolism
Diabetes. Impaired glucose tolerance
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Feeding. Feeding behavior
Female
Fundamental and applied biological sciences. Psychology
Glycated Hemoglobin
glycative stress
Humans
Hyperglycemia - drug therapy
Hyperglycemia - metabolism
Hypoglycemic Agents - pharmacology
Hypoglycemic Agents - therapeutic use
inflammation
Insulin - analogs & derivatives
Insulin - pharmacology
Insulin - therapeutic use
Insulin, Long-Acting
Interleukin-6 - metabolism
Male
Medical sciences
Middle Aged
Original
oxidative stress
postprandial glucose
Postprandial Period
pro-inflammatory cytokines
Treatment Outcome
Tumor Necrosis Factor-alpha - metabolism
United States
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Vertebrates: endocrinology
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Summary:Diabet. Med. 28, 1088–1095 (2011) Aim  To determine if a regimen with prandial + basal insulin compared with basal insulin attenuates post‐meal inflammatory and glycative biomarkers in patients with Type 2 diabetes. Methods  This test‐meal sub‐study in the USA is from a previously reported clinical trial comparing the effect on glycaemic control of 24 weeks of thrice‐daily pre‐meal insulin lispro mix 50 (50% insulin lispro, 50% insulin lispro protamine suspension) or bedtime insulin glargine, both plus metformin. In the sub‐study, glucose, insulin, triglycerides, high‐sensitivity C‐reactive protein, tumour necrosis factor α, interleukin‐6, methylglyoxal and 3‐deoxyglucosone were measured during the post‐meal period of a mixed‐meal breakfast at the final visit. Prandial + basal (n = 25) and basal (n = 21) insulin were administered at the same times as during the previous 24 weeks. Results  Post‐meal, the prandial + basal insulin group had significantly higher insulin, lower glucose and triglycerides, as well as lower high‐sensitivity C‐reactive protein, tumour necrosis factor α and interleukin‐6, than the basal insulin group. Glucose incremental area under the concentration curve significantly correlated with high‐sensitivity C‐reactive protein, tumour necrosis factor α, interleukin‐6, methylglyoxal and 3‐deoxyglucosone incremental area under the concentration curve. Insulin incremental area under the concentration curve correlated inversely with high‐sensitivity C‐reactive protein and tumour necrosis factor α incremental area under the concentration curve. However, after adjusting for glucose incremental area under the concentration curve, these inverse correlations were no longer significant. Triglyceride incremental area under the concentration curve was not correlated with any biomarker incremental area under the concentration curve. Conclusions  Controlling post‐meal hyperglycaemia with prandial + basal insulin in patients with Type 2 diabetes attenuates meal‐induced increases in high‐sensitivity C‐reactive protein, interleukin‐6 and tumour necrosis factor α compared with basal insulin. The rise in post‐meal glucose, but not triglycerides, significantly correlated with the rise in post‐meal inflammatory and glycative biomarkers.
ISSN:0742-3071
1464-5491
DOI:10.1111/j.1464-5491.2011.03324.x