Differential Effects of Medications and Gastric Banding on OGTT-Modeled Measures of beta-Cell Function in Adults with IGT or Recent-Onset Type 2 Diabetes (T2D)

We compared 3-hr OGTT model-derived measures of insulin sensitivity and β-cell function after 12 mo treatment with placebo (PLAC), metformin (MET), liraglutide plus MET (L+M), 3 mo glargine followed by 9 mo MET (G/M) and gastric banding (GB) in adults with IGT or T2D in the Restoring Insulin Secretion (RISE) Study. Modeling parameters included insulin sensitivity (OGIS), insulin secretion rate (ISR) at reference glucose 6.5 mM (ISR@6.5), total integrated ISR (tISR), glucose sensitivity (GS: slope ISR vs. glucose concentration) and rate sensitivity (RS: ISR relative to glucose rate of change). Adjusted linear mixed models compared model parameters over time within and between each study arm. Results: Baseline model parameters did not differ by treatment arm. OGIS increased in all groups except PLAC. ISRs and GS increased in L+M but decreased or were unchanged in the other treatment arms. RS only increased in the G/M and GB arms. Treatment effects differed by arm. For L+M, GS and ISRs were increased vs. all other arms. For GB, RS was increased and tISR decreased vs. PLAC and GS was increased vs. MET. In summary, L+M augments insulin secretion and increases GS, while GB increases RS. Clinically, both L+M and GB appear to improve β-cell function at 12 mo and may benefit adults with IGT or recent-onset T2D while on treatment. Disclosure K. Utzschneider: Other Relationship; Self; Medtronic. L. El Ghormli: None. S. Sam: None. D.A. Ehrmann: None. K.J. Mather: Research Support; Self; Abbott, Merck \u0026 Co., Inc., Novo Nordisk Inc., Sanofi. E. Barengolts: None. T.S. Hannon: None. M. Tripputi: None. S. Edelstein: None. A. Mari: Consultant; Self; Lilly Diabetes. Research Support; Self; Boehringer Ingelheim International GmbH. T. Consortium: None. Funding American Diabetes Association (1-14-RISE-01); National Institute of Diabetes and Digestive and Kidney Diseases