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Fasting proinsulin concentrations predict the development of type 2 diabetes
N J Wareham1, C D Byrne, R Williams
1Department of Community Medicine, University of Cambridge, England, U.K. njw1004@medschl.cam.ac.uk
Diabetes Care
|May 20, 1999
Summary
Fasting 32,33 split proinsulin levels predict future type 2 diabetes development. This marker offers better prediction than insulin or intact proinsulin, identifying high-risk individuals for targeted interventions.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Diabetes Research
Background:
- Split proinsulin is the predominant form of proinsulin.
- Disproportionate hyperproinsulinemia is observed in type 2 diabetes.
- Specific assays enable separate measurement of proinsulin processing molecules.
Purpose of the Study:
- To investigate if split proinsulin concentration predicts diabetes development.
- To compare the predictive power of split proinsulin with other markers.
Main Methods:
- A population-based longitudinal cohort study in Ely, Cambridgeshire.
- 1,122 participants completed an oral glucose tolerance test (OGTT) at baseline.
- Repeat OGTTs were performed at a 4.5-year follow-up on 937 non-diabetic individuals.
Main Results:
- 26 individuals progressed to diabetes.
- Fasting 32,33 split proinsulin (RR 16.4) and fasting glucose (RR 17.6) strongly predicted progression.
- Associations were independent of age, sex, BMI, and baseline glucose tolerance.
- A high-risk subgroup (family history, high fasting glucose, and total proinsulin) had a 30% progression rate.
Conclusions:
- Fasting 32,33 split proinsulin independently predicts diabetes development.
- Split proinsulin offers superior prediction compared to insulin or intact proinsulin.
- Combining family history, fasting glucose, and total proinsulin identifies high-risk individuals for interventions.