Impaired glucagon secretion in patients with fulminant type 1 diabetes mellitus
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Fulminant type 1 diabetes mellitus (FT1DM), characterized by rapid and almost complete destruction of pancreatic β-cells, is a newly identified subtype of type 1 diabetes mellitus. Although, the pathophysiology of this condition remains still unclear, histological evidence suggests that not only β-cells but also α-cells of pancreatic islets are reduced in number in FT1DM. However, the ability of glucagon secretion in patients with this condition has remained largely uncharacterized. We therefore examined glucagon secretion in patients with FT1DM and compared that with patients with other types of diabetes mellitus.
Fasting glucagon levels as well as glucagon secretion induced by intravenous administration of arginine were measured in hospitalized 83 patients with diabetes mellitus, including 4 with FT1DM, 18 with type 1 diabetes mellitus (T1DM), 40 with type 2 diabetes mellitus (T2DM), 5 with slowly progressive insulin-dependent diabetes mellitus (SPIDDM), and 16 with pancreatic diabetes mellitus (PDM).
The area under the curve for serum glucagon levels after arginine infusion in FT1DM patients was significantly smaller than that in T1DM, T2DM, or SPIDDM patients but was similar to that in PDM patients. The fasting serum glucagon level of FT1DM patients was lower than that of T1DM or T2DM patients but did not significantly differ from that of SPIDDM or PDM patients.
These results suggest that glucagon secretion is impaired in patients with FT1DM.
KeywordsFulminant Type 1 diabetes Glucagon Japanese
The authors thank Naoko Hashimoto, Tomoko Nishiumi, Ayumi Kanno, and Kentaro Suda for assistance with data collection as well as Yutaka Takahashi and Genzo Iguchi of Kobe University Graduate School of Medicine for helpful discussion.
This study was supported by a Research Grant from the Ministry of Education, Culture, Sports, Science, and Technology of Japan to S.S. and Y.H.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the ethics committee of Kobe University Graduate School of Medicine (approval no. 180044). All patients provided written consent to the analysis and publication of their clinical data for scientific purposes.
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