Pathogenic factors responsible for glucose intolerance in patients with NIDDM

Taniguchi, A.; Nakai, Yoshikatsu; Fukushima, M.; Kawamura, Hideo; Imura, H.; Nagata, I; Tokuyama, Kunpei

doi:10.2337/diabetes.41.12.1540

Cited by 68 publications

(54 citation statements)

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“…It is, however, less efficient than some other tests that provide data across a greater range of patients [20,21]. We used a bolus insulin dose of 0.02 IU/kg in the insulin-modified FSIVGTT as recommended [38] and similar to that used in another study in which it was shown that this dose is a good match to peripheral plasma glucose and insulin responses from a tolbutamide-modified FSIVGTT [39]. Although it is possible that a larger insulin bolus could make the test more applicable in insulin resistant and diabetic patients, the dose we used was sufficient to induce hypoglycaemia in some normal subjects.…”

Section: Discussionmentioning

confidence: 99%

Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes

et al. 1999

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Impaired glucose tolerance (IGT) and Type II (noninsulin-dependent) diabetes mellitus result from different contributions of deficient insulin secretion and impaired insulin sensitivity [1±8]. Routine quantification of these abnormalities is rarely done as simple, user friendly methods have not been validated or received general approval [9,10]. The choice of therapy might depend on the causative pathophysiology in a patient and, with the prospect of insulin-sensitising drugs as well as life-style changes to improve insulin sensitivity, routine assessment of insulin sensitivity might become more appropriate than at present [11, Diabetologia (1999) AbstractAims/hypothesis. Adequate comparison of the relative performance of insulin sensitivity tests is not yet available. We compared the discrimination of four insulin sensitivity tests, commonly used in vivo, across a range of glucose tolerance. Methods. Normal (n = 7), impaired glucose tolerant (n = 8) and Type II (non-insulin-dependent) diabetic subjects (n = 9) had in random order two tests from the following: frequently sampled insulin-modified intravenous glucose tolerance test (FSIVGTT-MinMod); homeostasis model assessment (HOMA) and 2-h continuous infusion of glucose with model assessment (CIGMA) with immunoreactive or specific insulin; short insulin tolerance tests (ITT). The discriminatory power of tests was assessed by the ratio of the within-subject standard deviation to the underlying between-subject standard deviation (discriminant ratio ± DR). The degree to which tests measured the same variable was assessed by comparing rank correlation with the maximum expected correlation given the imprecision of the tests. The unbiased lines of equivalence taking into account the precision of tests were constructed.Results. Reciprocal fasting plasma insulin (FPI ±1 ), HOMA %S and 2-h CIGMA %S, had similar DRs with ITT being less informative. The FSIVGTT-MinMod analysis was able to assess 13 out of 24 subjects and had a performance similar to ITT. Using specific rather than immunoreactive insulin for HOMA-CIG-MA did not improve the DR. Reciprocal fasting plasma insulin FPI ±1 , HOMA %S, 2-h CIGMA %S and S I FSIVGTT intercorrelated more than 90 % of the expected rank correlation given the imprecision of the tests, but ITT gave only limited correlation. Conclusion/interpretation. The HOMA-CIGMA test with immunoreactive insulin provides similar information in distinguishing insulin sensitivity between subjects with normal glucose tolerance, those with impaired glucose tolerance and those with Type II diabetes as does FSIVGTT, whereas ITT is less informative. [Diabetologia (1999) 42: 678±687]

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Section: Discussionmentioning

confidence: 99%

Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes

et al. 1999

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“…The glucose disappearance constant (K G ) was calculated as the slope of the least-squares regression line related to the natural logarithm of the glucose concentration to the time from samples drawn between 10 and 19 min. The S I and S G were estimated using a minimal-model approach (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). The S I index represents the increase in the net glucose disappearance rate, which, in turn, depends on the rise in insulin above the basal level.…”

Section: Discussionmentioning

confidence: 99%

Effect of Mild Exercise Training on Glucose Effectiveness in Healthy Men

Nishida

Higaki²,

Tokuyama³

et al. 2001

Diabetes Care

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OBJECTIVE -To detect whether mild exercise training improves glucose effectiveness (S G ), which is the ability of hyperglycemia to promote glucose disposal at basal insulin, in healthy men.RESEARCH DESIGN AND METHODS -Eight healthy men (18 -25 years of age) underwent ergometer training at lactate threshold (LT) intensity for 60 min/day for 5 days/week for 6 weeks. An insulin-modified intravenous glucose tolerance test was performed before as well as at 16 h and 1 week after the last training session. S G and insulin sensitivity (S I ) were estimated using a minimal-model approach.RESULTS -After the exercise training, VO 2max and VO 2 at LT increased by 5 and 34%, respectively (P Ͻ 0.05). The mild exercise training improves S G measured 16 h after the last training session, from 0.018 Ϯ 0.002 to 0.024 Ϯ 0.001 min Ϫ1 (P Ͻ 0.05). The elevated S G after exercise training tends to be maintained regardless of detraining for 1 week (0.023 Ϯ 0.002 min Ϫ1 , P ϭ 0.09). S I measured at 16 h after the last training session significantly increased (pre-exercise training, 13.9 Ϯ 2.2; 16 h, 18.3 Ϯ 2.4, ϫ10 Ϫ5 ⅐ min Ϫ1 ⅐ pmol/l -1 , P Ͻ 0.05) and still remained elevated 1 week after stopping the training regimen (18.6 Ϯ 2.2, ϫ10 Ϫ5 ⅐ minCONCLUSIONS -Mild exercise training at LT improves S G in healthy men with no change in the body composition. Improving not only S I but also S G through mild exercise training is thus considered to be an effective method for preventing glucose intolerance.

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“…Most white people with type 2 diabetes present with IR [9], which is strongly associated with obesity, whereas most Japanese patients with type 2 diabetes do not have IR [10]. Furthermore, insulin secretion in Japanese individuals is reported to be less than half that in whites [11,12].…”

Section: Introductionmentioning

confidence: 99%

Impact of impaired insulin secretion and insulin resistance on the incidence of type 2 diabetes mellitus in a Japanese population: the Saku study

et al. 2013

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Aims/hypothesis To assess the impact of impaired insulin secretion (IIS) and insulin resistance (IR) on type 2 diabetes incidence in a Japanese population. Methods This 4 year cohort study included 3,059 participants aged 30-69 without diabetes at baseline who underwent comprehensive medical check-ups between April 2006 and March 2007 at Saku Central Hospital. Based on their insulinogenic index and HOMA-IR values, participants were classified by the criteria of the Japan Diabetes Society into four categories: normal; isolated IIS (i-IIS); isolated IR (i-IR); and IIS plus IR. They were followed up until March 2011. The incidence of type 2 diabetes was determined from fasting and 2 h post-load plasma glucose concentrations and from receiving medical treatment for diabetes. Results At baseline, 1,550 individuals (50.7%) were classified as normal, 900 (29.4%) i-IIS, 505 (16.5%) i-IR, and 104 (3.4%) IIS plus IR. During 10,553 person-years of follow-up, 219 individuals developed type 2 diabetes, with 126 (57.5%) having i-IIS at baseline. Relative to the normal group, the multivariable-adjusted HRs for type 2 diabetes in the i-IIS, i-IR and IIS plus IR groups were 8.27 (95% CI 5.33, 12.83), 4.90 (95% CI 2. 94, 8.17) and 16.93 (95% CI 9.80, 29.25), respectively. The population-attributable fractions of type 2 diabetes onset due to i-IIS, i-IR, and IIS plus IR were 50.6% (95% CI 46.7%, 53.0%), 14.2% (95% CI 11.8%, 15.6%) and 12.9% (95% CI 12.3%, 13.2%), respectively. Conclusions/interpretation Compared with IR, IIS had a greater impact on the incidence of type 2 diabetes in a Japanese population.

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Pathogenic factors responsible for glucose intolerance in patients with NIDDM

Cited by 68 publications

References 0 publications

Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes

Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes

Effect of Mild Exercise Training on Glucose Effectiveness in Healthy Men

Impact of impaired insulin secretion and insulin resistance on the incidence of type 2 diabetes mellitus in a Japanese population: the Saku study

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