Beta-cell function in treatment-naïve patients with type 2 diabetes mellitus: Analyses of baseline data from 15 clinical trials

Abstract

Progressive decline of β-cell function is a hallmark of disease progression in type 2 diabetes mellitus (T2DM). β-cell dysfunction may precede the onset of T2DM by several years.1 Studies show a decline of approximately 50% in β-cell function at T2DM diagnosis, with a further drop of 4% expected each year.2 Landmark longitudinal studies such as the Veterans Affairs Diabetes Trial (VADT) and the United Kingdom Prospective Diabetes Study (UKPDS) have demonstrated the importance of β-cell function in maintaining glycaemic control and as an indicator of disease status.3,4 A progressive decline in C-peptide levels from diagnosis until 18 years of diabetes duration was observed in the VADT, while in the UKPDS, homeostatic model assessment of β-cell function (HOMA-B) was 50% at time of diagnosis and 28% after 6 years. Early intervention is deemed as a potential approach in reducing the risk of complications due to hyperglycaemia, and β-cell status may play a crucial role in clinical decision making to facilitate appropriate and timely treatment initiation