RT Journal Article
T1 Beta cell functionality and hepatic insulin resistance are major contributors to type 2 diabetes remission and starting pharmacological therapy: from CORDIOPREV randomized controlled trial
A1 Roncero-ramos, Irene
A1 Gutierrez-mariscal, Francisco M.
A1 Gomez-delgado, Francisco
A1 Villasanta-gonzalez, Alejandro
A1 Torres-pena, Jose D.
A1 de la Cruz-ares, Silvia
A1 Rangel-zuniga, Oriol A.
A1 Luque, Raul M.
A1 Ordovas, Jose M.
A1 Delgado-lista, Javier
A1 Perez-martinez, Pablo
A1 Camargo, Antonio
A1 Alcala-diaz, Juan F.
A1 Lopez-miranda, Jose
K1 Glucose-production
K1 Cardiovascular-disease
K1 Fat accumulation
K1 Glycemic control
AB In order to assess whether previous hepatic IR (Hepatic-IRfasting) and beta-cell functionality could modulate type 2 diabetes remission and the need for starting glucose-lowering treatment, newly-diagnosed type 2 diabetes participants who had never received glucose-lowering treatment (190 out of 1002) from the CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (a prospective, randomized and controlled clinical trial), were randomized to consume a Mediterranean or a low-fat diet. Type 2 diabetes remission was defined according to the American Diabetes Association recommendation for levels of HbA1c, fasting plasma glucose and 2h plasma glucose after oral glucose tolerance test, and having maintained them for at least 2 consecutive years. Patients were classified according to the median of Hepatic-IRfasting and beta-cell functionality, measured as the disposition index (DI) at baseline. Cox proportional hazards regression determined the potential for Hepatic-IRfasting and DI indexes as predictors of diabetes remission and the probability of starting pharmacological treatment after a 5-year follow-up. Low-Hepatic-IRfasting or high-DI patients had a higher probability of diabetes remission than high-Hepatic-IRfasting or low-DI subjects (HR:1.79; 95% CI 1.06-3.05; and HR:2.66; 95% CI 1.60-4.43, respectively) after a dietary intervention with no pharmacological treatment and no weight loss. The combination of low Hepatic-IRfasting and high-DI presented the highest probability of remission (HR:4.63; 95% CI 2.00-10.70). Among patients maintaining diabetes, those with high Hepatic-IRfasting and low-DI showed the highest risk of starting glucose-lowering therapy (HR:3.24;95% CI 1.50-7.02). Newly-diagnosed type 2 diabetes patients with better beta-cell functionality and lower Hepatic-IRfasting had a higher probability of type 2 diabetes remission in a dietary intervention without pharmacological treatment or weight loss, whereas among patients not achieving remission, those with worse beta-cell functionality and higher Hepatic-IRfasting index had the highest risk of starting glucose-lowering treatment after 5 years of follow-up.
PB Elsevier
SN 1931-5244
YR 2021
FD 2021-07-14
LK http://hdl.handle.net/10668/18890
UL http://hdl.handle.net/10668/18890
LA en
NO Roncero-Ramos I, Gutierrez-Mariscal FM, Gomez-Delgado F, Villasanta-Gonzalez A, Torres-Peña JD, Cruz-Ares S, et al. Beta cell functionality and hepatic insulin resistance are major contributors to type 2 diabetes remission and starting pharmacological therapy: from CORDIOPREV randomized controlled trial. Transl Res. 2021 Dec;238:12-24
NO The CORDIOPREV study is supported by the Fundacion Patrimonio Comunal Olivarero, by Junta de Andalucia (Consejeria de Salud, Consejeria de Agricultura y Pesca, Consejeria de Innovacion, Ciencia y Empresa CVI-7450 to J. L-M), Diputaciones de Jaen y Cordoba, Centro de Excelencia en Investigacion sobre Aceite de Oliva y Salud and Ministerio de Medio Ambiente, Medio Rural y Marino, Gobierno de España. The CORDIOPREV study has also received research grants from the Ministerio de Economia y Competitividad (AGL2012/39615 and AGL2015-67896-P to J. L-M, FIS PI10/01041 to P. P-M, FIS PI13/00023 to J. D-L), integrated into the framework of the National Plan for Scientific Research, Techno logical Development and Innovation 2013-2016, co financed by the Instituto de Salud Carlos III (ISCIII) of Spain, the Directorate General for Assessment and Pro motion of Research and the EU’s European Regional Development Fund (FEDER). The CIBEROBN is an initiative of the ISCIII. Funding for open access charge: Universidad de C ordoba/CBUA. Irene Roncero-Ramos is supported by an ISCIII postdoctoral research contract (Programa Sara Borrell CD16/00047). Francisco M Gutierrez-Mariscal is supported by a CIBEROBN postdoctoral research contract. The contents of this paper are not intended for any commercial use
DS RISalud
RD Apr 7, 2025