Impaired glucose tolerance as a disorder of insulin action. Longitudinal and cross-sectional studies in Pima Indians - PubMed (original) (raw)
Impaired glucose tolerance as a disorder of insulin action. Longitudinal and cross-sectional studies in Pima Indians
S Lillioja et al. N Engl J Med. 1988.
Abstract
Impaired glucose tolerance often presages the development of non-insulin-dependent diabetes mellitus. We have studied insulin action and secretion in 24 Pima Indians before and after the development of impaired glucose tolerance and in 254 other subjects representing the whole spectrum of glucose tolerance, including subjects with overt non-insulin-dependent diabetes. The transition from normal to impaired glucose tolerance was associated with a decrease in glucose uptake during hyperinsulinemia, from 0.018 to 0.016 mmol per minute (from 3.3 to 2.8 mg per kilogram of fat-free body mass per minute) (P less than 0.0003). Mean plasma insulin concentrations increased during an oral glucose-tolerance test, from 1200 to 1770 pmol per liter (from 167 to 247 microU per milliliter). In 151 subjects with normal glucose tolerance, the insulin concentration measured during an oral glucose-tolerance test correlated with the plasma glucose concentration (r = 0.48, P less than or equal to 0.0001). This relation was used to predict an insulin concentration of 1550 pmol per liter (216 microU per milliliter) in subjects with impaired glucose tolerance (actual value, 1590 pmol per liter [222 microU per milliliter]; P not significant), suggesting that these subjects had normal secretion of insulin. In contrast, plasma insulin concentrations in the diabetics decreased as glucose concentrations increased (r = -0.75, P less than or equal to 0.0001), suggesting deficient secretion of insulin. This relative insulin deficiency first appears at the lower end of the second (diabetic) mode seen in population frequency distributions of plasma glucose concentrations. Our data show that impaired glucose tolerance in our study population is primarily due to impaired insulin action. In patients with non-insulin-dependent diabetes mellitus, by contrast, impaired insulin action and insulin secretory failure are both present.
Similar articles
- Relationship of hepatic and peripheral insulin resistance with plasminogen activator inhibitor-1 in Pima Indians.
Nagi DK, Tracy R, Pratley R. Nagi DK, et al. Metabolism. 1996 Oct;45(10):1243-7. doi: 10.1016/s0026-0495(96)90242-5. Metabolism. 1996. PMID: 8843179 - Defects in insulin secretion and insulin action in non-insulin-dependent diabetes mellitus are inherited. Metabolic studies on offspring of diabetic probands.
Vauhkonen I, Niskanen L, Vanninen E, Kainulainen S, Uusitupa M, Laakso M. Vauhkonen I, et al. J Clin Invest. 1998 Jan 1;101(1):86-96. doi: 10.1172/JCI716. J Clin Invest. 1998. PMID: 9421470 Free PMC article. - Elevated plasma nonesterified fatty acids are associated with deterioration of acute insulin response in IGT but not NGT.
Stefan N, Stumvoll M, Bogardus C, Tataranni PA. Stefan N, et al. Am J Physiol Endocrinol Metab. 2003 Jun;284(6):E1156-61. doi: 10.1152/ajpendo.00427.2002. Epub 2003 Feb 11. Am J Physiol Endocrinol Metab. 2003. PMID: 12582008 Clinical Trial. - Reduced early insulin secretion in the etiology of type 2 diabetes mellitus in Pima Indians.
Bogardus C, Tataranni PA. Bogardus C, et al. Diabetes. 2002 Feb;51 Suppl 1:S262-4. doi: 10.2337/diabetes.51.2007.s262. Diabetes. 2002. PMID: 11815490 Review. - The role of impaired early insulin secretion in the pathogenesis of Type II diabetes mellitus.
Pratley RE, Weyer C. Pratley RE, et al. Diabetologia. 2001 Aug;44(8):929-45. doi: 10.1007/s001250100580. Diabetologia. 2001. PMID: 11484070 Review.
Cited by
- Intracellular pH Regulation of Skeletal Muscle in the Milieu of Insulin Signaling.
Posa DK, Baba SP. Posa DK, et al. Nutrients. 2020 Sep 23;12(10):2910. doi: 10.3390/nu12102910. Nutrients. 2020. PMID: 32977552 Free PMC article. Review. - Acute psychological stress results in the rapid development of insulin resistance.
Li L, Li X, Zhou W, Messina JL. Li L, et al. J Endocrinol. 2013 Apr 15;217(2):175-84. doi: 10.1530/JOE-12-0559. Print 2013 May. J Endocrinol. 2013. PMID: 23444388 Free PMC article. - Hypertension and non-insulin dependent diabetes.
Yudkin JS. Yudkin JS. BMJ. 1991 Sep 28;303(6805):730-2. doi: 10.1136/bmj.303.6805.730. BMJ. 1991. PMID: 1796956 Free PMC article. No abstract available. - New insights into the pathogenesis of insulin resistance in humans using magnetic resonance spectroscopy.
Petersen KF, Shulman GI. Petersen KF, et al. Obesity (Silver Spring). 2006 Feb;14 Suppl 1(0 1):34S-40S. doi: 10.1038/oby.2006.280. Obesity (Silver Spring). 2006. PMID: 16642961 Free PMC article. Review. - Association of skeletal muscle mass and its change with diabetes occurrence: a population-based cohort study.
Xu Y, Hu T, Shen Y, Wang Y, Bao Y, Ma X. Xu Y, et al. Diabetol Metab Syndr. 2023 Mar 22;15(1):53. doi: 10.1186/s13098-023-01027-8. Diabetol Metab Syndr. 2023. PMID: 36945053 Free PMC article.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical