Korean Diabetes J.  2010 Jun;34(3):157-165. 10.4093/kdj.2010.34.3.157.

The Changes in Early Phase Insulin Secretion in Newly Diagnosed, Drug Naive Korean Prediabetes Subjects

• Rhee SY
• Kim JY
• Chon S
• Hwang YC
• Jeong IK
• Oh S
• Ahn KJ
• Chung HY
• Woo JT
• Kim SW
• Kim JW
• Kim YS

• KMID: 2222371
• DOI: http://doi.org/10.4093/kdj.2010.34.3.157

Abstract

BACKGROUND
There have been no systematic observations regarding changes in early phase insulin secretion among Korean prediabetes and early stage type 2 diabetes mellitus (T2DM) patients.
METHODS
We conducted 75-g oral glucose tolerance tests (OGTT) in 873 subjects with suspected abnormal glucose tolerance. All subjects were diagnosed as having normal glucose tolerance (NGT), prediabetes (preDM), or T2DM according to the OGTT results and the insulin secretory and insulin resistance indices of each subject were calculated. Additionally, we analyzed the changes in early phase insulin secretion according to changes in fasting (Glc(0)), post-prandial (Glc(120)) glucose and HbA1c (A1c) levels.
RESULTS
As compared to subjects with NGT, the insulin secretory indices of the preDM and T2DM subjects progressively declined, and the insulin resistance indices were progressively aggravated. Early phase insulin secretion decreased rapidly according to the increments of Glc(0), Glc(120) and A1c, and these changes were most prominent in the NGT stage. Compared to the control group, the early phase insulin secretion levels of the preDM or T2DM subjects were less than 50% when Glc(0) was over 100 mg/dL, Glc(120) was over 145 mg/dL, and A1c was over 5.8%.
CONCLUSION
This study suggests that progressive beta cell dysfunction in Koreans may be initiated and rapidly aggravated during the period generally designated as 'normal.'

Keyword

Blood glucose; Diabetes mellitus, type 2; Hyperglycemia; Insulin; Insulin resistance; Korea; Prediabetes state

MeSH Terms

Blood Glucose
Diabetes Mellitus, Type 2
Fasting
Glucose
Glucose Tolerance Test
Humans
Hyperglycemia
Insulin
Insulin Resistance
Korea
Prediabetic State
Blood Glucose
Glucose
Insulin

Figure

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  Fig. 1 Relationship between fasting plasma glucose and early phase insulin secretion. Data represents the means and 95% confidence intervals. IGI, insulinogenic index; HOMA-IR, homeostasis model assessment-insulin resistance; ACR, acute C-peptide response. aRefers to P < 0.05 vs. F1 (FPG ≤ 86 mg/dL), bP < 0.01 vs. F1, cP < 0.05 vs. F2 (FPG 87-95 mg/dL), dP < 0.01 vs. F2.

• 

  Fig. 2 Relationship between postprandial plasma glucose and early phase insulin secretion. Data represents means and 95% confidence intervals. IGI, insulinogenic index; HOMA-IR, homeostasis model assessment-insulin resistance; ACR, acute C-peptide response. aRefers to P < 0.05 vs. P1 (PP2 < 112 mg/dL), bP < 0.01 vs. P1, cP < 0.05 vs. P2 (PP2 113-132 mg/dL), dP < 0.01 vs. P2.

• 

  Fig. 3 Relationship between postprandial plasma glucose and early phase insulin secretion. Data represents means and 95% confidence intervals. IGI, insulinogenic index; HOMA-IR, homeostasis model assessment-insulin resistance; ACR, acute C-peptide response. aRefers to P < 0.05 vs. H1 (HbA1c < 5.0%), bP < 0.01 vs. H1, cP < 0.05 vs. H2 (HbA1c 5.1-5.2%), dP < 0.01 vs. H2.

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