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Click to add/remove this article to your list of 'My Favorites' β Cell Failure in Type 2 Diabetes Mellitus: Microvascular Pancreatic Isletopathy?

Abstract Number: 2316-PO


Institutions: Phoenix, AZ; Iowa City, IA.

Results: UKPDS suggested relentless deterioration of β cell function as a part of natural course of type 2 diabetes mellitus (DM2). However, the course was apparently not universal since almost 25% of patients maintained glycemic goal (<7.0%) at 9 years while receiving oral agents. Moreover, the exact mechanism of progressive β cell failure is unclear. It is plausible that β cell failure may be due to microangiopathy of pancreatic islets since no organ or tissue is exempt from this complication. Therefore we examined the occurrence of β cell failure in 300 men with ages 40-75 years and duration of DM 4-23 years. Subjects were divided into 4 groups according to number of microvascular manifestations (MM) i.e., retinopathy, nephropathy, and neuropathy. β cell failure

(β -ve) is defined as HbA1c > 7.0% with any therapy or HbA1c <7.0% with insulin either monotherapy or in combination with oral agents. β cell function is deemed intact (β +ve) with HbA1c <7.0% with diet and oral drugs. The results are shown below

Table 1
No. of MM0123
β + ve85 (65)32 (34)*5 (11)†5 (16)†
β - ve46 (35)62 (66)*39 (89)†26 (84)†
Total131 (100)94 (100)44 (100)31 (100)
% of patients are shown in parentheses; * - p <0.01 vs. group 0; † - p < 0.001 vs. group 0Prevalence of β cell failure was progressive with increasing numbers of microvascular manifestations. Therefore, the β cell failure may also be a manifestation of microvascular pancreatic isletopathy.

Category: Epidemiology