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Vol 2, No 2 (2001): Practical Diabetology
Original articles (translated)
Published online: 2001-03-08
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Insulin resistance and insulin secretory dysfunction are independent predictors of worsening of glucose tolerance during each stage of type 2 diabetes development

Christian Weyer, P. Antonio Tataranni, Clifton Bogardus, Richard E. Pratley
Diabetologia Praktyczna 2001;2(2):167-172.

open access

Vol 2, No 2 (2001): Practical Diabetology
Original articles (translated)
Published online: 2001-03-08

Abstract

OBJECTIVE. Although prospective studies indicate that insulin resistance and insulin secretory dysfunction predict type 2 diabetes, they provide limited information on the relative contributions of both abnormalities to worsening glucose tolerance at different developmental stages of the disease. We therefore assessed the predictive effect of insulin resistance and insulin secretory dysfunction separately for the progression from normal glucose tolerance (NGT) to impaired glucose tolerance (IGT) and from IGT to diabetes.
RESEARCH DESIGN AND METHODS. Insulin-stimulated glucose disposal (M) (hyperinsulinemic clamp), acute insulin secretory response (AIR) (25-g intravenous glucose tolerance test), and body composition (hydrodensitometry or dual-energy X-ray absorptiometry) were measured in 254 Pima Indians with NGT and in 145 Pima Indians with IGT, who were then followed for 0.5–13 years.
RESULTS. After follow-ups of 4.4 ± 3.1 and 5.5 ± 3.4 years, 79 (31%) of the subjects with initial NGT had developed IGT, and 64 (44%) of the subjects with initial IGT had developed diabetes. In proportional-hazards analyses with adjustment for age, sex, and percent body fat, low M and low AIR were independent predictors of both the progression from NGT to IGT (relative hazards [95% CI] for 10th vs. 90th percentile: M2.4 [1.2–4.7], P < 0.02; AIR 2.1 [1.1–4.1], P < 0.04) and from IGT to diabetes (M2.5 [1.3–5.0], P < 0.01; AIR 1.8 [0.99–3.3], P = 0.055).
CONCLUSIONS. During each stage of the development of type 2 diabetes, insulin resistance and insulin secretory dysfunction are independent predictors of worsening glucose tolerance and are, therefore, both targets for the primary prevention of the disease.

Abstract

OBJECTIVE. Although prospective studies indicate that insulin resistance and insulin secretory dysfunction predict type 2 diabetes, they provide limited information on the relative contributions of both abnormalities to worsening glucose tolerance at different developmental stages of the disease. We therefore assessed the predictive effect of insulin resistance and insulin secretory dysfunction separately for the progression from normal glucose tolerance (NGT) to impaired glucose tolerance (IGT) and from IGT to diabetes.
RESEARCH DESIGN AND METHODS. Insulin-stimulated glucose disposal (M) (hyperinsulinemic clamp), acute insulin secretory response (AIR) (25-g intravenous glucose tolerance test), and body composition (hydrodensitometry or dual-energy X-ray absorptiometry) were measured in 254 Pima Indians with NGT and in 145 Pima Indians with IGT, who were then followed for 0.5–13 years.
RESULTS. After follow-ups of 4.4 ± 3.1 and 5.5 ± 3.4 years, 79 (31%) of the subjects with initial NGT had developed IGT, and 64 (44%) of the subjects with initial IGT had developed diabetes. In proportional-hazards analyses with adjustment for age, sex, and percent body fat, low M and low AIR were independent predictors of both the progression from NGT to IGT (relative hazards [95% CI] for 10th vs. 90th percentile: M2.4 [1.2–4.7], P < 0.02; AIR 2.1 [1.1–4.1], P < 0.04) and from IGT to diabetes (M2.5 [1.3–5.0], P < 0.01; AIR 1.8 [0.99–3.3], P = 0.055).
CONCLUSIONS. During each stage of the development of type 2 diabetes, insulin resistance and insulin secretory dysfunction are independent predictors of worsening glucose tolerance and are, therefore, both targets for the primary prevention of the disease.
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Keywords

glucose tolerance; diabetes; type 2 diabetes; insulin

About this article
Title

Insulin resistance and insulin secretory dysfunction are independent predictors of worsening of glucose tolerance during each stage of type 2 diabetes development

Journal

Clinical Diabetology

Issue

Vol 2, No 2 (2001): Practical Diabetology

Pages

167-172

Published online

2001-03-08

Bibliographic record

Diabetologia Praktyczna 2001;2(2):167-172.

Keywords

glucose tolerance
diabetes
type 2 diabetes
insulin

Authors

Christian Weyer
P. Antonio Tataranni
Clifton Bogardus
Richard E. Pratley

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