AIMS: To compare OGTT-derived estimates of beta-cell function between youth and adults with impaired glucoslerance (IGT) or recently diagnosed type 2 diabetes after treatment discontinuation in RISE. METHODS: Youth (n = 89) and adults (n = 132) were randomized to 3 months glargine followed by 9 months metformin (G/M) or 12 months metformin (MET). Insulin sensitivity and beta-cell responses were estimated from 3-hour OGTTs over 21 months. Linear mixed models tested for differences by time and age group within each treatment arm. RESULTS: After treatment withdrawal, HbA1c increased in both youth and adults with a larger net increase in G/M youth vs. adults at 21 months. Among youth, beta-cell function decreased starting at 12 months in G/M and 15 months in MET. Among adults, beta-cell function remained relatively stable although insulin secretion rates decreased in G/M at 21 months. At 21 months vs. baseline beta-cell function declined to a greater extent in youth vs. adults in both the G/M and MET treatment arms. CONCLUSIONS: After treatment withdrawal youth demonstrated progressive decline in beta-cell function after stopping treatment with either G/M or MET. In contrast, beta-cell function in adults remained stable despite an increase in HbA1c over time. ClinicalTrials.gov Identifier: NCT01779375 and NCT01779362 at clinical trials.gov.
Reference Type
Journal Article
Periodical Full
Diabetes research and clinical practice
Publication Year
2021
Publication Date
August 01
Volume
178
Start Page
108948
Publisher
Elsevier B.V
Place of Publication
Ireland
ISSN/ISBN
1872-8227
Accession Number
PMID: 34274407
Document Object Index
S0168-8227(21)00308-9 [pii]
PMID
34274407
PMCID
PMC8628318