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J Diabetes Investig. 2014 Sep;5(5):570-80. doi: 10.1111/jdi.12181. Epub 2013 Dec 26.

Secretory units of islets in transplantation index is a useful predictor of insulin requirement in Japanese type 2 diabetic patients.

Author information

1
First Department of Internal Medicine University of Toyama Toyama Japan ; Community Medical Support Unit Faculty of Medicine University of Toyama Toyama Japan.
2
Department of Clinical Research National Center for Global Health and Medicine Tokyo Japan.
3
First Department of Internal Medicine University of Toyama Toyama Japan.
4
Department of Internal Medicine Asahi General Hospital Asahi-machi Japan.
5
Department of Internal Medicine Kamiichi General Hospital Kamiichi-machi Japan.
6
Department of Internal Medicine Saiseikai Toyama Hospital Toyama Japan.
7
Division of Endocrinology and Metabolism Department of Internal Medicine Saiseikai Takaoka Hospital Takaoka Toyama Japan.
8
Department of Internal Medicine Shakaihoken Takaoka Hospital Takaoka Toyama Japan.
9
Department of Public Health University of Toyama Toyama Japan.

Abstract

AIMS/INTRODUCTION:

The objective of the present study was to clarify the validity of β-cell function-related parameters for predicting the insulin requirement of Japanese type 2 diabetic patients.

MATERIALS AND METHODS:

In 188 patients with type 2 diabetes who had been admitted to the University of Toyama Hospital (Toyama, Japan) without receiving insulin therapy, we carried out a cross-sectional study examining the relationship between the homeostasis model assessment of β-cell function (HOMA-β) and C-peptide-based indices, and also carried out a retrospective study to examine the utility for predicting insulin requirement of several β -cell function-related indices using a receiver operating characteristic (ROC) curve analysis.

RESULTS:

The secretory units of islets in transplantation index (SUIT) had the strongest correlation with HOMA-β, followed by the fasting serum C-peptide immunoreactivity index (CPI); the fasting serum C-peptide immunoreactivity itself (F-CPR) had the least correlation. The CPI, HOMA-β and SUIT were significantly lower in the insulin-requiring group than in the non-insulin-requiring group, even after adjustments for confounding factors (P < 0.01). The areas under the ROC curve for insulin requirement were 0.622, 0.774, 0.808, and 0.759 for F-CPR, CPI, SUIT, and HOMA-β, respectively. The cut-off values of SUIT, CPI, and HOMA-β for an over 80% specificity for the prediction of insulin therapy were 23.5, 1.00, and 14.9, respectively.

CONCLUSIONS:

The present study shows that SUIT is the best predictor of insulin requirement among these β-cell function-related markers.

KEYWORDS:

Insulin requirement; Type 2 diabetes; β‐cell function

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