Association of the glycemic fluctuation as well as glycemic control with the pancreatic β-cell function in Japanese subjects with type 2 diabetes mellitus

Abstract

Objective It is important to preserve the pancreatic β-cell function in order to maintain good glycemic control for a long period. The aim of this study was to examine which factors are associated with the β-cell function in subjects with type 2 diabetes mellitus. Methods A total of 372 subjects with type 2 diabetes who had been hospitalized for the amelioration of their glycemic control and/or education about diabetes in Kawasaki Medical School Hospital were included in this study. We evaluated the remnant β-cell function as the HOMA-%β using the computer software program HOMA2 and estimated the glycemic fluctuation with the glycoalbumin (GA)/hemoglobin A1c (HbA1c) ratio. In addition, we divided the subjects into a relatively young group (<65 years old) (n=210) and an elderly group (≥65 years old) (n=162) and performed several analyses in each group. Results The GA/HbA1c ratio, GA and HbA1c were independent determinant factors for the HOMA-%β regardless of age. We obtained almost the same results even after excluding those subjects using insulin secre-tagogues. These data suggest that the glycemic fluctuation and glycemic control are associated with the remnant β-cell function in Japanese subjects with type 2 diabetes. Conclusion It is very important to reduce glycemic fluctuation as well as to maintain good glycemic control in order to preserve β-cell function in subjects with type 2 diabetes.