Correction of hyperglycaemia reduces insulin resistance and serum soluble E-selectin levels in patients with Type 2 diabetes mellitus

Authors


Dr Kazunari Matsumoto, Department of Internal Medicine, Sasebo Chuo Hospital, 15 Yamato-cho, Sasebo, Nagasaki 857–1195, Japan.

Abstract

SUMMARY

Aims  To investigate the effects of glycaemic control on insulin sensitivity and serum concentrations of soluble vascular cell adhesion molecule (sVCAM)-1 and E-selectin (sE-selectin) in patients with Type 2 diabetes mellitus. To examine whether reductions in serum adhesion molecule levels correlate with improvement in insulin resistance.

Methods  A total of 54 patients with Type 2 diabetes were treated for 4 weeks with either diet alone, sulphonylurea or insulin. Fasting glucose, insulin sensitivity, lipids, sVCAM-1, and sE-selectin levels were measured before and after treatment.

Results  All treatment modalities successfully corrected hyperglycemia. Reductions in blood glucose levels resulted in improvement in insulin sensitivity (diet KITT 2.40 ± 0.26–3.09 ± 0.36, P < 0.01; sulphonylurea 2.24 ± 0.16–2.94 ± 0.18, P < 0.01; insulin 1.68 ± 0.27–2.16 ± 0.22%/min, P < 0.05), and decrease in sE-selectin levels (diet 88.4 ± 14.9–66.2 ± 10.8, P < 0.05; sulphonylurea 85.1 ± 11.6–59.8 ± 7.8, P < 0.01; insulin 84.4 ± 8.7–66.8 ± 7.4 ng/ml, P < 0.01), but no change in sVCAM-1 levels. There was a significant correlation between the degree of decrease in sE-selectin levels and improvement in insulin sensitivity (r = −0.38, P < 0.01).

Conclusions  Correction of hyperglycaemia, independent of treatment modality, resulted in improvement of insulin resistance and decrease in sE-selectin levels. These changes might, in part, contribute to reduce the risk of diabetic microvascular and macrovascular complications in patients with Type 2 diabetes mellitus.

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