:Indices for Impaired Insulin Secretion and Insulin Resistance
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In order to analyze the oral glucose tolerance test in non-obesesubjects (normal: 96, borderline: 109, type 2 diabetes: 137), a data processing method was applied for evaluation. According to the fasting plasma glucose level, the patients with diabetes were subdivided into 3 groups (mild: FPG≤140 mg/d<I>l</I>, moderate: 140<FPG≤200 mg/d<I>l</I>, severe: FPG> 200 mg/d<I>l</I>). The following results were obtained.<BR>1) In subjects with borderline, mild and moderate diabetes, the IRI/glucose values at fasting were not decreased, suggesting that decreased insulin sensitivity may play a role in fasting hyperglycemia in such subjects.<BR>2) The insulin responses to glucose load were significantly impaired and delayed even in mild and moderate diabetic subjects. Regarding the increased glucose area from the fasting plasma glucose levels (Σ(ΔG)), normal and borderline subjects showed a greater glycemic response after 1 hour (<SUP>60</SUP>Σ<SUB>0</SUB> (ΔG)><SUP>120</SUP>Σ<SUB>60</SUB> (ΔG)), while diabetics showed an inverse relation (<SUP>60</SUP>Σ<SUB>0</SUB> (ΔG)<<SUP>120</SUP>Σ<SUB>60</SUB> (ΔG)). These results suggested that both the secretion and effectiveness of insulin were abnormal in the diabetic state.<BR>3) In severe diabetics, the IRI/glucose value at fasting decreased, and the insulin response was similarly low and delayed.<BR>4) The following factors which separated glucose intolerance better and reflected insulin sensitivity are proposed.<BR>(Gp/I, <SUP>120</SUP>Σ<SUB>60</SUB>G/<SUP>60</SUP>Σ<SUB>0</SUB>I, <SUP>120</SUP>Σ<SUB>60</SUB> (ΔG)/<SUP>60</SUP>Σ<SUB>0</SUB> (ΔI))<BR>The IRI area during 120 min (<SUP>120</SUP>Σ<SUB>0</SUB>I) was higher in subjects with borderline glucose intolerance, but lowered in severe diabetes, and there were no differences in total insulin area (<SUP>120</SUP>Σ<SUB>0</SUB>I) between mild (moderate) diabetes and normals.<BR>These results indicate that glucose intolerance in type 2 diabetes results not only from impaired insulin secretion but also from decreased insulin sensitivity. Determination of insulin as well as glucose during OGTT is useful for the quantification of such abnormalities.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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