Usefulness of Minimal Model Analysis: Measurement of Insulin Sensitivity, Glucose Effectiveness, and Insulin Secretory Capacity from Pancreatic Islet Cells in Children with Simple Obesity or Type 2 Diabetes Mellitus

Kim, Se Young; Yang, Sei Won

Abstract

PURPOSE: It is known that insulin resistance and compensatory hyperinsulinemia from pancreatic islet cells to overcome insulin resistance could develop in children with simple obesity. When insulin resistance is aggravated by decompensation of high insulin secretion, obese children frequently progress to overt type 2 diabetes mellitus(DM). The purpose of the present study was to measure insulin sensitivity, glucose effectiveness, and insulin secretory capacity in children with simple obesity(n=15, 10.77+/-2.62 yr) and type 2 DM(n=10, 14.22+/-1.76yr) by frequently sampled intravenous glucose tolerance test.
METHODS
The data was analyzed as SI(insulin sensitivity), SG(glucose effectiveness) by Bergman's modified minimal model. Insulin secretory capacity was calculated as the area under the insulin curve between 0 and 19 minutes after administration of glucose(AUC, Insulin).
RESULTS
SI, KG, and insulin secretory capacity were significantly lower in children with type 2 DM than those in children with simple obesity(P<0.05). SG was not significantly different in both groups. There is a significant correlation between fasting glucose/insulin ratio and SI in the children with simple obesity.
CONCLUSION
These results suggest that higher insulin resistance and lower insulin secretory capacity tend to progress to overt type 2 DM in obese children. Frequently sampled intravenous glucose tolerance test might be useful in predicting to progress to overt type 2 DM by serial follow up of SI in children with simple obesity. Fasting glucose/insulin can be used as a screening test to evaluate insulin resistance in children with simple obesity.