Insulin resistance limits corneal nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control
Abstract Aims/Introduction This study aimed to investigate whether insulin resistance (IR) in individuals with type 2 diabetes undergoing intensive glycemic control determines the extent of improvement in neuropathy. Materials and Methods This was an exploratory substudy of an open‐label, randomized...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-11-01
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| Series: | Journal of Diabetes Investigation |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jdi.13582 |
| _version_ | 1819117591992467456 |
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| author | Georgios Ponirakis Muhammad A Abdul‐Ghani Amin Jayyousi Mahmoud A Zirie Salma Al‐Mohannadi Hamad Almuhannadi Ioannis N Petropoulos Adnan Khan Hoda Gad Osama Migahid Ayman Megahed Murtaza Qazi Fatema AlMarri Fatima Al‐Khayat Ziyad Mahfoud Ralph DeFronzo Rayaz A Malik |
| author_facet | Georgios Ponirakis Muhammad A Abdul‐Ghani Amin Jayyousi Mahmoud A Zirie Salma Al‐Mohannadi Hamad Almuhannadi Ioannis N Petropoulos Adnan Khan Hoda Gad Osama Migahid Ayman Megahed Murtaza Qazi Fatema AlMarri Fatima Al‐Khayat Ziyad Mahfoud Ralph DeFronzo Rayaz A Malik |
| author_sort | Georgios Ponirakis |
| collection | DOAJ |
| description | Abstract Aims/Introduction This study aimed to investigate whether insulin resistance (IR) in individuals with type 2 diabetes undergoing intensive glycemic control determines the extent of improvement in neuropathy. Materials and Methods This was an exploratory substudy of an open‐label, randomized controlled trial of individuals with poorly controlled type 2 diabetes treated with exenatide and pioglitazone or insulin to achieve a glycated hemoglobin <7.0% (<53 mmol/mol). Baseline IR was defined using homeostasis model assessment of IR, and change in neuropathy was assessed using corneal confocal microscopy. Results A total of 38 individuals with type 2 diabetes aged 50.2 ± 8.5 years with (n = 25, 66%) and without (n = 13, 34%) IR were studied. There was a significant decrease in glycated hemoglobin (P < 0.0001), diastolic blood pressure (P < 0.0001), total cholesterol (P < 0.01) and low‐density lipoprotein (P = 0.05), and an increase in bodyweight (P < 0.0001) with treatment. Individuals with homeostasis model assessment of IR <1.9 showed a significant increase in corneal nerve fiber density (P ≤ 0.01), length (P ≤ 0.01) and branch density (P ≤ 0.01), whereas individuals with homeostasis model assessment of IR ≥1.9 showed no change. IR was negatively associated with change in corneal nerve fiber density after adjusting for change in bodyweight (P < 0.05). Conclusions Nerve regeneration might be limited in individuals with type 2 diabetes and IR undergoing treatment with pioglitazone plus exenatide or insulin to improve glycemic control. |
| first_indexed | 2024-12-22T05:35:25Z |
| format | Article |
| id | doaj.art-4da42dc68bbf499e9433d197bed72255 |
| institution | Directory Open Access Journal |
| issn | 2040-1116 2040-1124 |
| language | English |
| last_indexed | 2024-12-22T05:35:25Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj.art-4da42dc68bbf499e9433d197bed722552022-12-21T18:37:20ZengWileyJournal of Diabetes Investigation2040-11162040-11242021-11-0112112002200910.1111/jdi.13582Insulin resistance limits corneal nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic controlGeorgios Ponirakis0Muhammad A Abdul‐Ghani1Amin Jayyousi2Mahmoud A Zirie3Salma Al‐Mohannadi4Hamad Almuhannadi5Ioannis N Petropoulos6Adnan Khan7Hoda Gad8Osama Migahid9Ayman Megahed10Murtaza Qazi11Fatema AlMarri12Fatima Al‐Khayat13Ziyad Mahfoud14Ralph DeFronzo15Rayaz A Malik16Weill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarNational Diabetes Center Hamad General Hospital Hamad Medical Corporation Doha QatarNational Diabetes Center Hamad General Hospital Hamad Medical Corporation Doha QatarNational Diabetes Center Hamad General Hospital Hamad Medical Corporation Doha QatarWeill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarWeill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarWeill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarWeill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarWeill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarNational Diabetes Center Hamad General Hospital Hamad Medical Corporation Doha QatarNational Diabetes Center Hamad General Hospital Hamad Medical Corporation Doha QatarWeill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarWeill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarWeill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarWeill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarDivision of Diabetes University of Texas Health Science Center San Antonio Texas USAWeill Cornell Medicine in Qatar Qatar Foundation Education City, Doha QatarAbstract Aims/Introduction This study aimed to investigate whether insulin resistance (IR) in individuals with type 2 diabetes undergoing intensive glycemic control determines the extent of improvement in neuropathy. Materials and Methods This was an exploratory substudy of an open‐label, randomized controlled trial of individuals with poorly controlled type 2 diabetes treated with exenatide and pioglitazone or insulin to achieve a glycated hemoglobin <7.0% (<53 mmol/mol). Baseline IR was defined using homeostasis model assessment of IR, and change in neuropathy was assessed using corneal confocal microscopy. Results A total of 38 individuals with type 2 diabetes aged 50.2 ± 8.5 years with (n = 25, 66%) and without (n = 13, 34%) IR were studied. There was a significant decrease in glycated hemoglobin (P < 0.0001), diastolic blood pressure (P < 0.0001), total cholesterol (P < 0.01) and low‐density lipoprotein (P = 0.05), and an increase in bodyweight (P < 0.0001) with treatment. Individuals with homeostasis model assessment of IR <1.9 showed a significant increase in corneal nerve fiber density (P ≤ 0.01), length (P ≤ 0.01) and branch density (P ≤ 0.01), whereas individuals with homeostasis model assessment of IR ≥1.9 showed no change. IR was negatively associated with change in corneal nerve fiber density after adjusting for change in bodyweight (P < 0.05). Conclusions Nerve regeneration might be limited in individuals with type 2 diabetes and IR undergoing treatment with pioglitazone plus exenatide or insulin to improve glycemic control.https://doi.org/10.1111/jdi.13582Corneal confocal microscopyDiabetic peripheral neuropathyInsulin resistance |
| spellingShingle | Georgios Ponirakis Muhammad A Abdul‐Ghani Amin Jayyousi Mahmoud A Zirie Salma Al‐Mohannadi Hamad Almuhannadi Ioannis N Petropoulos Adnan Khan Hoda Gad Osama Migahid Ayman Megahed Murtaza Qazi Fatema AlMarri Fatima Al‐Khayat Ziyad Mahfoud Ralph DeFronzo Rayaz A Malik Insulin resistance limits corneal nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control Journal of Diabetes Investigation Corneal confocal microscopy Diabetic peripheral neuropathy Insulin resistance |
| title | Insulin resistance limits corneal nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| title_full | Insulin resistance limits corneal nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| title_fullStr | Insulin resistance limits corneal nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| title_full_unstemmed | Insulin resistance limits corneal nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| title_short | Insulin resistance limits corneal nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| title_sort | insulin resistance limits corneal nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| topic | Corneal confocal microscopy Diabetic peripheral neuropathy Insulin resistance |
| url | https://doi.org/10.1111/jdi.13582 |
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