Valsartan Improves β-Cell Function and Insulin Sensitivity in Subjects With Impaired Glucose Metabolism

April 2011
Diabetes Care;Apr2011, Vol. 34 Issue 4, p845
Academic Journal
OBJECTIVE--Recently, the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research Trial demonstrated that treatment with the angiotensin receptor blocker (ARB) valsartan for 5 years resulted in a relative reduction of 14% in the incidence of type 2 diabetes in subjects with impaired glucose metabolism (IGM). We investigated whether improvements in β-cell function and/or insulin sensitivity underlie these preventive effects of the ARB valsartan in the onset of type 2 diabetes. RESEARCH DESIGN AND METHODS--In this randomized controlled, double-blind, two-center study, the effects of 26 weeks of valsartan (320 mg daily; n = 40) or placebo (n = 39) on β-cell function and insulin sensitivity were assessed in subjects with impaired fasting glucose and/or impaired glucose tolerance, using a combined hyperinsulinemic-euglycemic and hyperglycemic clamp with subsequent arginine stimulation and a 2-h 75-g oral glucose tolerance test (OGTT). Treatment effects were analyzed using ANCOVA, adjusting for center, glucometabolic status, and sex. RESULTS--Valsartan increased first-phase (P = 0.028) and second-phase (P = 0.002) glucose-stimulated insulin secretion compared with placebo, whereas the enhanced arginine-stimulated insulin secretion was comparable between groups (P = 0.25). In addition, valsartan increased the OGTT-derived insulinogenic index (representing first-phase insulin secretion after an oral glucose load; P = 0.027). Clamp-derived insulin sensitivity was significantly increased with valsartan compared with placebo (P = 0.049). Valsartan treatment significantly decreased systolic and diastolic blood pressure compared with placebo (P < 0.00l). BMI remained unchanged in both treatment groups (P = 0.89). CONCLUSIONS--Twenty-six weeks of valsartan treatment increased glucose-stimulated insulin release and insulin sensitivity in normotensive subjects with IGM. These findings may partly explain the beneficial effects of valsartan in the reduced incidence of type 2 diabetes.


Related Articles

  • Gluco-Beta Stimulator. Eiceman, Gail C.; Hassel, Elizabeth // Townsend Letter;Apr2014, Issue 369, p47 

    The article discusses the use of chromium, biotin, cinnamon and Gymnema sylvestre in the search for a product to treat diabetes that would intervene in the metabolic imbalance. It notes that a combination of chromium, biotin and cinnamon is most effective in lowering glucose levels and AIC...

  • Hypothalamic glucose sensor: Similarities to and differences from pancreatic beta-cell mechanisms. Xue-jun Yang; Kow, Lee-Ming; Funabashi, Toshiya; Mobbs, Charles V. // Diabetes;Sep99, Vol. 48 Issue 9, p1763 

    Suggests that glucose-responsive neurons sense glucose through glycolysis using a mechanism similar to the mechanism of pancreatic beta cells. Stimulation of glucose-responsive neurons by glycerol and lactate; Mechanism of glucose to regulate hypothalamic neuronal activity; Role of phlorizin in...

  • Depression of glucose levels and partial restoration of pancreatic β-cell damage by melatonin in streptozotocin-induced diabetic rats. Kanter, Mehmet; Uysal, Hamdi; Karaca, Turan; Sagmanligil, Hulya Ozdemir // Archives of Toxicology;Jun2006, Vol. 80 Issue 6, p362 

    Diabetes mellitus is a common but serious metabolic disorder associated with many functional and structural complications. Glucose metabolism is disturbed due to an absolute or relative insulin deficiency. The experiment was carried out to determine the effect of melatonin on blood glucose and...

  • Serotonin regulates pancreatic beta cell mass during pregnancy. Hail Kim; Toyofuku, Yukiko; Lynn, Francis C; Chak, Eric; Uchida, Toyoyoshi; Mizukami, Hiroki; Fujitani, Yoshio; Kawamori, Ryuzo; Miyatsuka, Takeshi; Kosaka, Yasuhiro; Yang, Katherine; Honig, Gerard; van der Hart, Marieke; Kishimoto, Nina; Wang, Juehu; Yagihashi, Soroku; Tecott, Laurence H; Watada, Hirotaka; German, Michael S. // Nature Medicine;Jul2010, Vol. 16 Issue 7, p804 

    During pregnancy, the energy requirements of the fetus impose changes in maternal metabolism. Increasing insulin resistance in the mother maintains nutrient flow to the growing fetus, whereas prolactin and placental lactogen counterbalance this resistance and prevent maternal hyperglycemia by...

  • Effects of combination therapy with vildagliptin and valsartan in a mouse model of type 2 diabetes. Miyagawa, Katsutosh; Kondo, Tatsuya; Goto, Rieko; Matsuyama, Rina; Ono, Kaoru; Kitano, Sayaka; Kawasaki, Shuji; Igata, Motoyuki; Kawashima, Junji; Matsumura, Takeshi; Motoshima, Hiroyuki; Araki, Eiichi // Cardiovascular Diabetology;2013, Vol. 12 Issue 1, p1 

    Background Dipeptidyl peptidase-4 (DPP-4) inhibitors modulate incretin hormones and exert anti-diabetic effects in type 2 diabetes mellitus. Treatment with angiotensin II type 1 receptor blockers (ARB) is a proven successful intervention for hypertension with type 2 diabetes. The present study...

  • Do oscillations of insulin secretion occur in the absence of cytoplasmic Ca2+ oscillations in beta-cells? Kjems, Lise L.; Ravier, Magalie A.; Jonas, Jean-Christophe; Henquin, Jean-Claude // Diabetes;Feb2002 Supplement, Vol. 51, pS177 

    That oscillations of the cytoplasmic free Ca(2+) concentration ([Ca(2+)](i)) in beta-cells induce oscillations of insulin secretion is not disputed, but whether metabolism-driven oscillations of secretion can occur in the absence of [Ca(2+)](i) oscillations is still debated. Because this...

  • Role of oscillations in membrane potential, cytoplasmic Ca2+, and metabolism for plasma insulin oscillations. Bergsten, Peter // Diabetes;Feb2002 Supplement, Vol. 51, pS171 

    A model for the relationship between ionic and metabolic oscillations and plasma insulin oscillations is presented. It is argued that the pancreatic beta-cell in vivo displays two intrinsic frequencies that are important for the regulation of plasma insulin oscillations. The rapid oscillatory...

  • Measurements of insulin secretory capacity and glucose tolerance to predict pancreatic beta-cell mass in vivo in the nicotinamide/streptozotocin Göttingen minipig, a model of moderate insulin deficiency and diabetes. Larsen, Marianne O.; Rolin, Bidda; Wilken, Michael; Carr, Richard D.; Gotfredsen, Carsten F. // Diabetes;Jan2003, Vol. 52 Issue 1, p118 

    Knowledge about beta-cell mass and/or function could be of importance for the early diagnosis and treatment of diabetes. However, measurement of beta-cell function as an estimate of beta-cell mass is currently the only method possible in humans. The present study was performed to investigate...

  • Learning From Glycosuria. Ferrannini, Ele // Diabetes;Mar2011, Vol. 60 Issue 3, p695 

    The author comments on the study "SGLT2 Deletion Improves Glucose Homeostasis and Preserves Pancreatic β-Cell Function." She discusses the functions of the SGLT-2, a member of the sodium glucose transporter (SGLT) family of transmembrane proteins. She explores the physiological effects of...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics