Abdul-Ghani

Benjamin

Bock

Carnevale Schianca

Davies

F. Bacha

Festa

Goran

Hanefeld

Meigs

Meyer

N. Gungor

S. A. Arslanian

S. Lee

The Expert Committee on the Diagnosis and Classifi

Tripathy

van Haeften

Weigensberg

Weyer

Williams

English

PubMed


                  OBJECTIVE
                  Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are considered pre-diabetes states. There are limited data in pediatrics in regard to their pathophysiology. We investigated differences in insulin sensitivity and secretion among youth with IFG, IGT, and coexistent IFG/IGT compared with those with normal glucose tolerance (NGT) and type 2 diabetes.
               
               
                  RESEARCH DESIGN AND METHODS
                  A total of 24 obese adolescents with NGT, 13 with IFG, 29 with IGT, 11 with combined IFG/IGT, and 30 with type 2 diabetes underwent evaluation of hepatic glucose production ([6,6-2H2]glucose), insulin-stimulated glucose disposal (Rd, euglycemic clamp), first- and second-phase insulin secretion (hyperglycemic clamp), body composition (dual-energy X-ray absorptiometry), abdominal adiposity (computed tomography), and substrate oxidation (indirect calorimetry).
               
               
                  RESULTS
                  Adolescents with NGT, pre-diabetes, and type 2 diabetes had similar body composition and abdominal fat distribution. Rd was lower (P = 0.009) in adolescents with type 2 diabetes than in those with NGT. Compared with adolescents with NGT, first-phase insulin was lower in those with IFG, IGT, and IFG/IGT with further deterioration in those with type 2 diabetes (P &amp;lt; 0.001), and β-cell function relative to insulin sensitivity (glucose disposition index [GDI]) was also lower in those with IFG, IGT, and IFG/IGT (40, 47, and 47%, respectively), with a further decrease (80%) in those with type 2 diabetes (P &amp;lt; 0.001). GDI was the major determinant of fasting and 2-h glucose levels.
               
               
                  CONCLUSIONS
                  Obese adolescents who show signs of glucose dysregulation, including abnormal fasting glucose, glucose intolerance or both, are more likely to have impaired insulin secretion rather than reduced insulin sensitivity. Given the impairment in insulin secretion, they are at high risk for progression to type 2 diabetes. Further deterioration in insulin sensitivity or secretion may enhance the risk for this progression.
               </jats:sec

Fida Bacha

SoJung Lee

Neslihan Gungor

Silva A. Arslanian

Crossref

Diabetes Care

From Pre-Diabetes to Type 2 Diabetes in Obese Youth

AmericanDiabetesAssociation.Screening for type 2 diabetes. Diabetes Care 2004; 27:(Suppl. 1)S11–S14 2. Benjamin

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2945164

From Pre-Diabetes to Type 2 Diabetes in Obese Youth: Pathophysiological characteristics along the spectrum of glucose dysregulation

From Pre-Diabetes to Type 2 Diabetes in Obese Youth: Pathophysiological characteristics along the spectrum of glucose dysregulation

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