Patricia Serradas

Improvement in glucose-induced insulin secretion in diabetic rats after long-term gliclazide treatment: A comparative study using different models of non-insulin-dependent diabetes mellitus induced by neonatal streptozotocin

Understanding of the long-term action of sulfonylureas in humans with non-insulin-dependent diabetes mellitus (NIDDM) may be facilitated by studying the effect of long-term sulfonylurea administration to animal models of the disease. In this study two different versions of the neonatal streptozotocin-induced diabetes (STZ) rat model of NIDDM were used. The n5-STZ model (STZ on day 5 after birth), which is characterized by basal hyperglycemia, a marked reduction of pancreatic insulin stores, and insulin resistance, and the n0-STZ model (STZ on day of birth), which develops mild hyperglycemia, have an approximately 50% reduction in pancreatic insulin content, and no insulin resistance. The diabetic rats were given oral gliclazide (10 mg/kg/day) and compared with untreated diabetic rats and nondiabetic rats. Insulin secretion was studied the day after the last gliclazide dose using the isolated perfused pancreas preparation. In severely hyperglycemic n5-STZ rats (plasma glucose levels greater than 16 mmol/L) the long-term gliclazide treatment did not lower the plasma glucose values, did not affect pancreatic insulin stores, and did not significantly modify in vitro insulin release in response to glucose or arginine. In moderately hyperglycemic n5-STZ rats (plasma glucose levels less than 16 mmol/L) the plasma glucose levels declined progressively and reached a mean of 8 mmol/L at the end of gliclazide therapy. The increase in pancreatic insulin stores in n5-STZ rats remained marginal. In the n0-STZ rats gliclazide treatment did not significantly modify the plasma glucose levels or the pancreatic insulin stores. After gliclazide therapy in both the n5-STZ gliclazide responder group and the n0-STZ group: (a) in vitro glucose-induced insulin secretion was increased three- to fivefold; (b) the response to arginine, which is increased in diabetic rats, was amplified by two- to threefold; (c) insulin release in response to gliclazide was unchanged. In conclusion, long-term gliclazide therapy augments stimulated insulin secretion in these two rat models of NIDDM and does not induce any refractoriness to short-term sulfonylurea administration. The improvement of beta-cell function observed here was not related to the concomitant variations of hyperglycemia and/or pancreatic insulin content.

Insulin secretion and glucose tolerance after islet transplantation in rats with noninsulin-dependent diabetes induced by neonatal streptozotocin

The present study was designed to identify in a model of noninsulin-dependent diabetes induced by neonatal streptozotocin (n0-STZ), the long-term consequences of an islet graft upon 1) glucose handling of the recipient and, 2) glucose response of the residual beta cells in the recipient pancreas. We have examined, 4 and 8 wk after islet implantation under the kidney capsule of syngeneic diabetic n0-STZ rats, their tolerance to glucose administered in vivo, together with their insulin release in response to glucose in vivo (oral glucose tolerance test) as well as in vitro (perfused pancreas). The results in the islet-grafted n0-STZ rats, were compared to those obtained in nongrafted nondiabetic rats and nongrafted n0-STZ rats. Our study shows that transplanting a limited number (900) of adult islets under the kidney capsule reverses to normal, many parameters of the noninsulin-dependent diabetic state in the n0-STZ rat model: these include body weight, basal plasma glucose in both the nonfasted and postabsorptive states, and basal plasma insulin in the postabsorptive state. Furthermore, tolerance to oral glucose administration was greatly improved in the transplanted rats and it was correlated with restoration of a manifest glucose-induced insulin secretion in vivo as evaluated (delta 1) during an oral glucose tolerance test. Our data clearly show that the insulin response to glucose from the endogenous pancreas of n0-STZ diabetic rat was not really improved by long-term (8 wk) basal normoglycemia. More precisely, we were able to detect a slight but significant improvement of the early phase of insulin release in vitro in response to glucose; however, the overall insulin response remained 15 times lower than the normal one with no reappearance of the late phase of insulin release. After cessation of glucose stimulation in vivo, off-response of insulin, which is also a landmark of the impaired insulin release by the beta cells of n0-STZ rats, was still detectable in the perfused pancreas of the transplanted n0-STZ rats. Finally, because the reactivity to glucose of the endogenous residual beta cells was not regained, the insulin released in vivo during the oral glucose test in the graft-bearing n0-STZ rats can be attributed mainly to functioning of the grafted islets population.

Transplantation of Syngenic Pancreatic Islets into Rats with Streptozotocin Induced Non Insulin Dependent Diabetes Mellitus

An important concept in understanding the pathogenesis of Non Insulin Dependent Diabetes Mellitus (NIDDM) has recently emerged: the concept that hyperglycemia is not only the principal metabolic derangement of diabetes but also a pathogenetic factor in its own right. Once it develops, either from insulin deficiency or from insulin resistance, hyperglycemia will exacerbate both defects, thereby closing a pathologic feedback loop1. Recognition of the important pathogenetic role of hyperglycemia per se in the evolution of NIDDM has important therapeutic implication. First normalization of the plasma glucose profile, should lead to an impairment in insulin secretion in NIDDM subjects. In fact significant improvements in insulin secretion and insulin action have been demonstrated after weight loss, sulfonylurea administration or insulin therapy, each of these therapeutic interventions leading to an improvement of glycemic control2.