A Non-obese, Treatment-Naive Japanese Diabetic Patient With Elevated Insulin Clearance and Hyperglycemia Under Enhanced Insulin Sensitivity and Increased Insulin Secretion: Elevated Insulin Clearance as Type 2 Japanese Diabetes Mellitus (T2JDM)

Abstract

Diabetes mellitus is a heterogeneous and complex metabolic disorder characterized by hyperglycemia secondary to either resistance to insulin actions on the liver and peripheral tissues, insufficient insulin secretion from pancreatic β-cells, or both. An integrated balance between blood insulin levels and wholebody insulin sensitivity could theoretically provide the clinical effectiveness of insulin action. Peripheral blood insulin concentrations might be determined by the capacity of endogenous pancreatic β-cell insulin secretion and the degree of the whole body insulin clearance. Here, we report a non-obese normoinsulinemic Japanese diabetic patient with elevated insulin clearance assessed by a hyperinsulinemiceuglycemic clamp examination and increased insulin secretion measured by daily urinary excretion of Cpeptide immunoreactivity. We propose this unique pathogenic condition of diabetes with normoinsulinemia and elevated insulin clearance as "type 2 Japanese diabetes mellitus (T2JDM)."

A Non-Obese Hyperglycemic Mouse Model that Develops after Birth with Low Birthweight

“…As other pathogeneses, increased insulin clearance [ 47 ], decreased pancreatic β-cell function [ 48 ], and enlarged fat cells [ 49 ] have been reported in the cause of non-obese type 2 diabetes. It is necessary to study if these causes exist in this model using biochemical, genetic, and histopathological analyses.…”