Renal denervation regulates blood glucose levels: JACC study
Germany: Renal denervation might also help in normalization of glucose homeostasis apart from offering a modest benefit in hypertension, finds a new study published in the Journal of the American College of Cardiology.
A previous study showed that the most valuable index for predicting functional beta-cell mass was a change of C-peptide by glucagon stimulation. Roland Schmieder, Friedrich-Alexander University Erlangen-Nürnberg in Germany, and colleagues argued that this is also a valid way to go about measuring the secretory capacity of the beta-cells.
The study involved 31 consecutive non-diabetic patients with treatment-resistant hypertension (on five antihypertensives on average). The cohort had a mean age of 57.7 years and 67.7% were men. Study participants were split between 22 with normal glucose homeostasis and nine with impaired fasting glucose.
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- Six months after renal denervation, non-diabetic patients showed better insulin control through their pancreatic beta-cells:
- Fasting glucose was down from 97.1 mg/dL to 92.3 mg/dL.
- Hemoglobin A1c dropped from 5.82% to 5.58%.
- Insulin resistance as assessed by the homeostasis model went from 2.25 to 1.94.
- C-peptide and insulin became more responsive to glucagon stimulation 6 months after renal denervation as well.
- Overall, 24-hour ambulatory blood pressure went from 150 mm Hg to 140 mm Hg at 6 months after renal denervation.
Renal denervation is known to reduce the central sympathetic activity, they noted.
"It is a small, but carefully done study. It shows an effect of renal denervation on sophisticated glycemic parameters. The findings are quite intriguing, especially since the authors state that there were no glucose-lowering drugs utilized, though these provocative results need to be replicated in a larger number of patients in a sham-controlled trial," commented Deepak Bhatt, MD, MPH, of Brigham and Women's Hospital, who was not involved in the study.
"Notably, we observed a relationship between beta-cell function and reduced fasting glucose 6 months after renal denervation that is predominantly determined by the insulin secretion overnight," concluded the study authors.