The relationship between insulin resistance and insulin secretion in japanese subjects with borderline glucose intolerance

• Published in: Diabetes research and clinical practice 1995-10, Vol.30 (1), p.53-57
• Main Authors: Wasada, Taro, Arii, Hiroko, Kuroki, Hiroyuki, Saeki, Akiko, Katsumori, Kozo, Saito, Setsu, Omori, Yasue
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Blood Glucose - metabolism; Borderline glucose intolerance (BGI); Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Euglycemic hyperinsulinemic clamp method; Female; Glucose Clamp Technique; Glucose Intolerance - blood; Glucose Intolerance - physiopathology; Glucose Tolerance Test; Humans; Insulin - blood; Insulin - metabolism; Insulin Resistance; Insulin Secretion; Japan; Male; Medical sciences; Middle Aged; Obesity - blood; Obesity - physiopathology; Reference Values; Regression Analysis; Statistics, Nonparametric
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/0168-8227(95)01149-8

Insulin resistance and impaired insulin secretion can be involved in the development of non-insulin-dependent diabetes mellitus (NIDDM), but their relative importance or temporal relationship are poorly understood. To elucidate this issue, we studied 51 subjects with borderline glucose intolerance (BGI) and 18 normal glucose tolerant subjects (NGT) according to the Japan Diabetes Society criteria. The glucose infusion rate (GIR, mg/kg/min), an index of whole body insulin resistance (IR), was measured by the euglycemic (80mg/dl) hyperinsulinemic clamp technique (insulin infusion rate 1.12mU/kg/min). Insulinogenic index ( ΔIRI ΔBS at 30 min) and the insulin area under the curve during a 75-g oral glucose tolerance test (OGTT) were estimated. In the BGI subjects, the GIR values showed marked variation ranging from 2.24 to 10.44 mg/kg/min (5.54 ± 0.31, mean ± S.E.M.). The GIR values were lower in obese BGI subjects compared with non-obese BGI and NGT subjects, and the insulin area was markedly higher in BGI subjects with increased insulin resistance. There was a significant negative correlation between the GIR values and the insulin area or ΔIRI ΔBS (30′) ratio in the subjects with BGI either in the whole group or solely in the non-obese group. We conclude that the increased insulin secretion compensates for the peripheral insulin resistance of subjects with slightly deteriorated glucose tolerance, implying that insulin resistance plays an important role in the pathogenesis of NIDDM in some fraction of Japanese population.