The relationship of insulin response to a glucose stimulus over a wide range of glucose tolerance

Zimmet, Paul; Whitehouse, S.; Alford, F.; Chisholm, D.

doi:10.1007/bf01219323

Cited by 62 publications

(43 citation statements)

References 12 publications

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“…In absolute terms, rates of insulin secretion, both in the basal state and following oral glucose, were, if anything, higher in IGT than NGT subjects, confirming a wealth of previous reports based on plasma insulin concentrations [34,35,36]. Incidentally, we found that, due to the reduced metabolic clearance rate of insulin, postglucose hyperinsulinaemia was more pronounced (+30% in IGT vs NGT) than true insulin hypersecretion (+15%).…”

Section: Discussionsupporting

confidence: 76%

Predominant role of reduced beta-cell sensitivity to glucose over insulin resistance in impaired glucose tolerance

Ferrannini

Gastaldelli

Miyazaki³

et al. 2003

Diabetologia

106

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Aims/hypothesis. Impaired glucose tolerance (IGT) is an insulin-resistant state and a risk factor for Type 2 diabetes. The relative roles of insulin resistance and insulin deficiency in IGT have been disputed. Methods. In 40 IGT subjects and 63 sex-, age-, and weight-matched controls with normal glucose tolerance (NGT), we measured (i) indices of insulin sensitivity of fasting glucose production (by tracer glucose) and glucose disposal (M value on a 240 pmol·min -1 ·m -2 insulin clamp) and (ii) indices of beta-cell function (glucose sensitivity, rate sensitivity, and potentiation) derived from model analysis (Am J Physiol 283:E1159-E1166, 2002) of the insulin secretory response (by C-peptide deconvolution) to oral glucose. Results. In comparison with NGT, IGT were modestly insulin resistant (M=29±2 vs 35±2 µmol·min −1 ·kg FFM −1 , p=0.01); insulin sensitivity of glucose production also was reduced, in approximate proportion to M. Despite higher baseline insulin secretion rates, IGT was characterized by a 50% reduction in glucose sensitivity [53 (36) concept has evolved that in IGT, a mixture of insulin resistance and insulin deficiency is responsible for the abnormal rise in postglucose plasma glucose concentrations [12,13]. However, many previous studies of IGT have based conclusions on the measurement of plasma insulin concentrations rather than true insulin secretion rates. More importantly, to what extent insulin response to intravenous glucose reflects the insulin secretory response to oral glucose or mixed meals remains uncertain. In studies using graded glucose infusions and the C-peptide deconvolution technique to reconstruct insulin secretory rates, one study [14] documented a slower rise in insulin secretion as a function of rising plasma glucose concentrations in IGT subjects in comparison with subjects with normal gluImpaired glucose tolerance (IGT) is a condition of high risk for the development of Type 2 diabetes. Early physiological studies consistently showed that IGT is an insulin-resistant state [1,2,3,4,5] and documented the presence of impaired insulin response to intravenous glucose [6,7,8,9,10,11]. The general

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Section: Discussionsupporting

confidence: 76%

Predominant role of reduced beta-cell sensitivity to glucose over insulin resistance in impaired glucose tolerance

Ferrannini

Gastaldelli

Miyazaki³

et al. 2003

Diabetologia

106

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“…This was clear almost a decade ago from a study from 13 Pacific countries [70]. The WHO FPG criterion for diabetes (7.8 mmol/l or 140 mg/dl) represents a greater degree of hyperglycaemia than the 2h-PG criterion for diabetes (11.1 mmol/l or 200 mg/dl) (Fig.…”

Section: New Diagnostic Criteria For Glucose Intolerancementioning

confidence: 95%

“…3). The diagnostic cut-point of 11.1 mmol/l (200 mg/dl) for the 2h-PG concentration was originally adopted as the bimodality in Pima Indians [69] and Nauruans [70]. It suggested that a plasma glucose concentration of approximately 11.1 mmol/l best represented the point separating the two components of the frequency distribution.…”

Section: New Diagnostic Criteria For Glucose Intolerancementioning

confidence: 99%

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Diabetes epidemiology as a tool to trigger diabetes research and care

1999

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“…To date, in spite of populational studies which relate insulin levels to those of glucose [22][23][24][25] , it should be noted that there are no criteria which safely establish hyperinsulinism 26 . Thus we have attempted to compare the study group to the control group, which consisted of eumenorrheic, non-hirsute and non-obese females with BMI <25 (Group I).…”

Section: Fig 3 -Levels Of Estradiol and Free-testosterone Before Andmentioning

confidence: 99%

Ovarian activity before and after gonadal suppression by GnRH-a in patients with polycystic ovary syndrome, hyperandrogenism, hyperinsulinism and acanthosis nigricans

Motta¹,

Baracat²,

Haidar³

et al. 1998

Rev. Assoc. Med. Bras.

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SUMMARY -OBJECTIVE.To investigate the ovarian activity before and after gonadal suppression with GnRH-analog in patients with PCO, hyperandrogenism, hyperinsulinism and acanthosis nigricans. Design: Controlled clinical study. Setting: Tertiary academic medical center. Patients: Six patients with clinical findings of PCO, hirsutism and acanthosis nigricans.INTERVENTIONS. Morning blood samples in the follicular phase to determine the steroid levels, glucose and insulin curve, comparing to a control group. Administration for 2 consecutive months of a GnRH-analog, comparing, in the study group, the free testosterone levels before and after ovarian suppression.MAIN OUTCOME MEASURE. Determination of insulin levels in PCO, hirsutism and acanthotic patients and the free-testosterone levels before and after gonadal suppression.RESULTS. Insulin levels were significantly higher in the study group when compared to normal women during the glycemic test. We also found a significant decrease in the free-testosterone levels after 2 months of gonadal suppression with GnRH-analog when compared to the initial time.CONCLUSIONS. Patients with PCO, hirsutism and acanthosis nigricans present high levels of insulin, suggesting an ovarian hyperesponsiveness, which is not sustained when gonadotrophic blockage was achieved.

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The relationship of insulin response to a glucose stimulus over a wide range of glucose tolerance

Cited by 62 publications

References 12 publications

Predominant role of reduced beta-cell sensitivity to glucose over insulin resistance in impaired glucose tolerance

Predominant role of reduced beta-cell sensitivity to glucose over insulin resistance in impaired glucose tolerance

Diabetes epidemiology as a tool to trigger diabetes research and care

Ovarian activity before and after gonadal suppression by GnRH-a in patients with polycystic ovary syndrome, hyperandrogenism, hyperinsulinism and acanthosis nigricans

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