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Major Pathophysiology in Prediabetes and Type 2 Diabetes: Decreased Insulin in Lean and Insulin Resistance in Obese
CONTEXT: Lowering of body mass index (BMI) to ≥25 kg/m(2) as obesity by ADA suggests insulin resistance as a major mechanism of impaired glucose metabolism (IGM) in Asians. However, glimepiride, an insulin secretagogue, delayed onset of type 2 diabetes (DM2) from prediabetes (PreDM), indicating decr...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Endocrine Society
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686647/ https://www.ncbi.nlm.nih.gov/pubmed/29264527 http://dx.doi.org/10.1210/js.2016-1116 |
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author | Kabadi, Udaya M. |
author_facet | Kabadi, Udaya M. |
author_sort | Kabadi, Udaya M. |
collection | PubMed |
description | CONTEXT: Lowering of body mass index (BMI) to ≥25 kg/m(2) as obesity by ADA suggests insulin resistance as a major mechanism of impaired glucose metabolism (IGM) in Asians. However, glimepiride, an insulin secretagogue, delayed onset of type 2 diabetes (DM2) from prediabetes (PreDM), indicating decreased insulin secretion (IS) as a major factor in lean (L; BMI < 27 kg/m(2)) subjects with IGM. OBJECTIVE: Assessment of IS and insulin resistance (IR) in L and obese (Ob; BMI ≥ 27 kg/m(2)) subjects with euglycemia (N), PreDM, and new onset DM2. SUBJECTS: Seventy-five men and 45 women ages 36 to 75 years were divided into six groups: LN, LPreDM, LDM2, ObN, ObPreDM, and ObDM2. METHODS: Determination of IS by insulinogenic indices (I/G) at fasting (FI/FG), first phase (∆I/∆G), and cumulative responses over 2 hours of OGTT (CRI/CRG), and IR by FIXFG, ∆IX∆G, and CRIXCRG. Changes in IS and IR for PreDM and DM2 were calculated as % fall and % rise, respectively, from levels in N. RESULTS: All indices of IS and IR were lower (P < 0.05) in L than corresponding Ob groups (P < 0.05). Moreover, decline in IS and rise in IR were progressive from N to PreDM (P < 0.05) and DM2 (P < 0.05) in both groups. However, the declines in IS were greater (P < 0.05) than rises in IR in LPreDM and LDM2. Whereas, the rises in IR were higher (P < 0.05) than declines in IS in ObPreDM and ObDM2. CONCLUSION: In L, major mechanism of IGM is declining IS and not rising IR documented among Ob. |
format | Online Article Text |
id | pubmed-5686647 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Endocrine Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-56866472017-12-20 Major Pathophysiology in Prediabetes and Type 2 Diabetes: Decreased Insulin in Lean and Insulin Resistance in Obese Kabadi, Udaya M. J Endocr Soc Clinical Research Articles CONTEXT: Lowering of body mass index (BMI) to ≥25 kg/m(2) as obesity by ADA suggests insulin resistance as a major mechanism of impaired glucose metabolism (IGM) in Asians. However, glimepiride, an insulin secretagogue, delayed onset of type 2 diabetes (DM2) from prediabetes (PreDM), indicating decreased insulin secretion (IS) as a major factor in lean (L; BMI < 27 kg/m(2)) subjects with IGM. OBJECTIVE: Assessment of IS and insulin resistance (IR) in L and obese (Ob; BMI ≥ 27 kg/m(2)) subjects with euglycemia (N), PreDM, and new onset DM2. SUBJECTS: Seventy-five men and 45 women ages 36 to 75 years were divided into six groups: LN, LPreDM, LDM2, ObN, ObPreDM, and ObDM2. METHODS: Determination of IS by insulinogenic indices (I/G) at fasting (FI/FG), first phase (∆I/∆G), and cumulative responses over 2 hours of OGTT (CRI/CRG), and IR by FIXFG, ∆IX∆G, and CRIXCRG. Changes in IS and IR for PreDM and DM2 were calculated as % fall and % rise, respectively, from levels in N. RESULTS: All indices of IS and IR were lower (P < 0.05) in L than corresponding Ob groups (P < 0.05). Moreover, decline in IS and rise in IR were progressive from N to PreDM (P < 0.05) and DM2 (P < 0.05) in both groups. However, the declines in IS were greater (P < 0.05) than rises in IR in LPreDM and LDM2. Whereas, the rises in IR were higher (P < 0.05) than declines in IS in ObPreDM and ObDM2. CONCLUSION: In L, major mechanism of IGM is declining IS and not rising IR documented among Ob. Endocrine Society 2017-05-10 /pmc/articles/PMC5686647/ /pubmed/29264527 http://dx.doi.org/10.1210/js.2016-1116 Text en Copyright © 2017 Endocrine Society https://creativecommons.org/licenses/by-nc-nd/4.0/ This article has been published under the terms of the Creative Commons Attribution Non-Commercial, No-Derivatives License (CC BY-NC-ND; https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Research Articles Kabadi, Udaya M. Major Pathophysiology in Prediabetes and Type 2 Diabetes: Decreased Insulin in Lean and Insulin Resistance in Obese |
title | Major Pathophysiology in Prediabetes and Type 2 Diabetes: Decreased Insulin in Lean and Insulin Resistance in Obese |
title_full | Major Pathophysiology in Prediabetes and Type 2 Diabetes: Decreased Insulin in Lean and Insulin Resistance in Obese |
title_fullStr | Major Pathophysiology in Prediabetes and Type 2 Diabetes: Decreased Insulin in Lean and Insulin Resistance in Obese |
title_full_unstemmed | Major Pathophysiology in Prediabetes and Type 2 Diabetes: Decreased Insulin in Lean and Insulin Resistance in Obese |
title_short | Major Pathophysiology in Prediabetes and Type 2 Diabetes: Decreased Insulin in Lean and Insulin Resistance in Obese |
title_sort | major pathophysiology in prediabetes and type 2 diabetes: decreased insulin in lean and insulin resistance in obese |
topic | Clinical Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686647/ https://www.ncbi.nlm.nih.gov/pubmed/29264527 http://dx.doi.org/10.1210/js.2016-1116 |
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