Ndei Beta Cell Slide Kit Can We Assess B Cell HealthPresentation Transcript
Section 3 How Can We Assess -Cell Health and Function?
-Cell Adaptation and Failure: Opportunities for Prevention and Treatment of Type 2 Diabetes
This slide kit is intended to provide current information on issues concerning -cells in patients with type 2 diabetes.
Some of the information and agents mentioned may include discussions of off-label, non–FDA-approved, or investigational uses. Please refer to each manufacturer’s full prescribing information before prescribing any of the agents mentioned in this program.
Slides that include discussion of off-label uses are identified with the symbol .
Tools to Assess -Cell Health and Function
Acute insulin response to glucose (usually IV administration)*
can be used to calculate the Disposition Index
Insulin secretion during hyperglycemia (fixed or increasing)*
Maximum insulin response to arginine during hyperglycemia*
Oscillatory insulin secretion patterns
Glucose-insulin relationships (fasting and during OGTT)
Glucose levels (reflect -cell compensation for insulin resistance)
*Should be expressed relative to degree of insulin resistance
Clinical Assessment of -Cell Function
Why not just measure insulin?
Fasting and stimulated insulin levels determined by -cell function and insulin resistance
No practical way to determine -cell compensation for insulin resistance from serum insulin values
Insulin assays are not standardized; cannot establish normal or at-risk values
Clinical Assessment of -Cell Function: Why Not Just Measure Insulin? Same β -cell function, different insulin levels Same insulin levels, different function Insulin sensitivity Insulin level Normal Patient #2 Patient #1 Insulin sensitivity Insulin level Normal Impaired Patient #4 Patient #3
Clinical Assessment of -Cell Function: Why Measure Glucose?
Glucose levels are determined by the interaction between insulin sensitivity (demand) and insulin secretion (supply)
Normally, supply changes to meet demand
if insulin sensitivity falls, insulin secretion rises reciprocally and vice versa
Failure to compensate results in elevated glucose levels. Thus, glucose levels reflect -cell compensation