The significance of tumor necrosis factor-α in newly diagnosed type 2 diabetic patients by transient intensive insulin treatment

Abstract

This study was performed to investigate whether transient intensive insulin therapy with an insulin pump (TIIT) can decrease serum tumor necrosis factor-α (TNF-α) and explore whether the decrease of serum TNF-α has correlation with the improvement of islet β-Cell function and the decrease of insulin resistance. Thirty healthy volunteers served as control subjects. One hundred and thirty-eight newly diagnosed type 2 diabetic patients had been treated with TIIT for 2 weeks. TNF-α, free fatty acids (FFAs), glucose, and insulin (INS) had been measured before and after TIIT, respectively. Homeostasis model assessment (HOMA) was used to estimate insulin resistance (HOMA-IR) and islet β-Cell function (HOMA-β). TNF-α was significantly increased in diabetes. After TIIT, TNF-α, fasting blood glucose, FFAs, and HOMA-IR were significantly decreased. HOMA-β and the areas under the curves of INS were significantly increased during intravenous glucose tolerance tests. TNF-α had not only significant negative correlation with the changes of insulin secretion, but also significant positive correlation with the changes of HOMA-IR after adjustment of blood glucose. Partial correlation analyses demonstrated that there was an indepenent relationship between TNF-α and HOMA-IR and HOMA-β. Our study confirms that TIIT can effectively decrease serum TNF-α in type 2 diabetes. It is inferred that the decrease of serum TNF-α might be involved in the improvement of β-Cell function and the decrease of insulin resistance by TIIT.