[Insulin resistance in offspring of type 2 diabetic patients]

Diabetes mellitus is the disease with heterogeneous aetiology. Among the causes of hyperglycaemia the insulin resistance with it's genetical background is mentioned. The aim of the study was the assessment of insulin resistance in healthy offspring of type 2 diabetic patients as well as assessment whether the coexistence of nephropathy in parents has an impact on insulin resistance in offspring. 56 subjects with positive familial history of diabetes type 2 divided into 2 groups were admitted. Subgroup A1 30 subjects (mean age 33.0 +/- 8.5 years) consisted of those who had familial history of diabetes without nephropathy and subgroup A2 26 subjects (mean age 33.0 +/- 6.5 years) with familial history of diabetic nephropathy. Control group consisted of 30 healthy volunteers without familial history. Euglycemic hyperinsulinemic clamp test was performed in all subjects studied. Tissue glucose uptake (TGU) was significantly lower while fasting insulinemia In0 was significantly higher in A1 and A2 groups when compared to controls (respectively TGU 5.6 +/- 2.2, 6.3 +/- 2.5 and 9.5 +/- 2.2 mg/kg/min p < 0.005, In0 19.4 +/- 8.3, 20.8 +/- 8.9 and 11.4 +/- 6.0 p < 0.001). No differences in TGU and In0 when compared A1 vs. A2 group were found. In-depth analysis did not show any differences in relation on whether diabetes was inherited from father's or mother's side. It was also shown that BMI did not interfere on insulin resistance in patients with positive familial history of diabetes. We conclude that insulin resistance has the genetical background and that insulin resistance and nephropathy are inherited separately.