Ling W, Wang YC, Huang Y, Ou YF, Jiang YC. Islet β-cell function preservation by different anti-diabetic treatments in Chinese elderly patients with type 2 diabetes mellitus. World J Diabetes 2025; 16(2): 94976 [DOI: 10.4239/wjd.v16.i2.94976]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Feb 15, 2025; 16(2): 94976 Published online Feb 15, 2025. doi: 10.4239/wjd.v16.i2.94976
Islet β-cell function preservation by different anti-diabetic treatments in Chinese elderly patients with type 2 diabetes mellitus
Wei Ling, Yan-Chao Wang, Yi Huang, Yang-Fu Ou, Yan-Chun Jiang
Wei Ling, Department of Science Laboratory, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin 541002, Guangxi Zhuang Autonomous Region, China
Yan-Chao Wang, Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin 541100, Guangxi Zhuang Autonomous Region, China
Yi Huang, Faculty of Basic Medicine, Guilin Medical University, Guilin 541100, Guangxi Zhuang Autonomous Region, China
Yang-Fu Ou, Department of Geriatrics, The Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
Yan-Chun Jiang, Department of Neurology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin 541002, Guangxi Zhuang Autonomous Region, China
Author contributions: Ling W design the study and draft the manuscript; Wang YC and Huang Y collect and generate the raw data; Ou YF and Jiang YC assembled and analyzed and/or interpretated the data; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of the Nanxishan Hospital of Guangxi Zhuang Autonomous Region (Approval No. NXSYY-2024-209).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have declared that no conflict of interests exists.
Data sharing statement: The raw data are available upon reasonable request from the corresponding author at lingwei19901016@163.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: March 29, 2024 Revised: September 7, 2024 Accepted: December 3, 2024 Published online: February 15, 2025 Processing time: 276 Days and 7 Hours
Abstract
BACKGROUND
The preservation of islet β-cell function in elderly patients with type 2 diabetes mellitus (T2DM) is a top priority for diabetic control.
AIM
To assess the preservation of islet β-cell function among elderly Chinese patients with T2DM after different anti-diabetic treatments.
METHODS
In this longitudinal observational study, elderly patients with T2DM treated with insulin, oral antidiabetic drugs or a combination of both were enrolled to disclose their islet β-cell function between baseline and follow-up. Islet β-cell function was determined by the plasma Homeostasis Model for β-cell function (HOMA-β), C-peptide and area under the curve (AUC) based on oral glucose tolerance test. Changes in β-cell function (decrement or increment from baseline) between different therapy groups were the outcomes.
RESULTS
In total, 745 elderly patients (≥ 60 years) with T2DM [insulin monotherapy, n = 105; oral anti-diabetic drugs (OAD) monotherapy, n = 321; insulin plus OAD, n = 319] had their baseline and follow-up β-cell function assessed during a median observation period of 4.5 years (range, 3.0-7.2 years). Overall, islet β-cell function (HOMA-β, fasting C-peptide, fasting insulin, AUCc-pep, AUCins, AUCc-pep/AUCglu, AUCins/AUCglu) consistently deteriorated over time regardless of the three different antidiabetic treatments. No statistical differences in decrement were observed among the three groups regarding the islet β-cell function indices. All three groups showed an increased ratio of delayed insulin secretion response after 4.5 years of observation.
CONCLUSION
In Chinese elderly patients with T2DM, islet β-cell function progressively declines regardless of insulin supplement or insulin plus OAD treatments.
Core Tip: In this longitudinal observational study, elderly type 2 diabetic patients receiving insulin, oral hypoglycemic drugs, or combination therapy were included to disclose their baseline and follow-up β-cell function. Results showed that islet β-cell function progressively decline regardless of any insulin supplement or oral antidiabetic treatments in Chinese elderly patients with type 2 diabetes.
