Conference abstract

Interventions for preservation of beta-cell functional mass in diabetes

Pan African Medical Journal - Conference Proceedings. 2021:11(13).20 Dec 2021.
doi: 10.11604/pamj-cp.2021.11.13.910

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Keywords: Beta cell function, mass, type II diabetes

Interventions for preservation of beta-cell functional mass in diabetes

Roberta Lamptey1,2,&, Mercy Anna Nuamah3

1Department of Family Medicine, Korle-Bu Teaching Hospital, Korle-Bu, Ghana, 2Department of Community Health, School of Public Health, University of Ghana, Ghana, 3Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Ghana

&Corresponding author

INTRODUCTION: type II diabetes is a global epidemic which imposes significant morbidity and mortality on affected persons. Progression of diabetes results from accelerated beta cell apoptosis and the resultant decline in beta cell functional mass. Interventions which delay progression of diabetes are key in halting diabetes complications. The objective is to conduct a systematic review of literature on interventions which preserve beta cell functional mass. METHODS: using data source from Pubmed, Cochrane database, prospective human studies on prevention of progression of type II diabetes and preservation of beta cell functional mass in adults with pre-diabetes and diabetes were compiled and compared. The interventions used in the studies reviewed were lifestyle modification, intensive insulin therapy, oral glucose lowering agents, non-insulin injectables and bariatric surgery. RESULTS: objective measures of beta cell function (HOMA-B, PI/I ratio, DI) can be improved by intensive insulin therapy initiated early in the disease process. Lifestyle interventions result in the delay of progression of diabetes. Glucotoxicity is a confounder when assessing the effect of an intervention on beta cell function. Oral hypoglycaemic agents improve beta cell function but durability of their effect is variable. GLP-1 agonists have the most durable effect on beta cell functional mass. CONCLUSION: significant beta cell destruction occurs in the pre-diabetes phase before diagnostic criteria for diabetes are met. Intensive insulin therapy, bariatric surgery and very low calorie diets are treatments that not only restore normoglycaemia but also prevent beta cell apoptosis if intervention is initiated early.