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Insulin-sensitive and insulin-resistant variants in NIDDM
1Department of Medicine, State University of New York Health Science Center, Brooklyn 11203.
Diabetes
|June 1, 1989
Summary
This study reveals two distinct groups of non-insulin-dependent diabetes mellitus (NIDDM) patients: one with normal insulin sensitivity and another with insulin resistance, characterized by elevated basal insulin levels and reduced hepatic glucose production.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Diabetes Pathogenesis
Background:
- Non-insulin-dependent diabetes mellitus (NIDDM) pathogenesis involves complex metabolic dysregulation.
- Understanding the sequence of events in NIDDM is crucial for developing effective treatments.
Purpose of the Study:
- To investigate the distinct pathophysiological mechanisms underlying non-insulin-dependent diabetes mellitus (NIDDM).
- To identify differences in insulin sensitivity and hepatic glucose production in NIDDM patients.
Main Methods:
- Utilized the euglycemic insulin clamp technique to assess peripheral insulin sensitivity in 16 NIDDM individuals.
- Measured basal plasma insulin levels and basal hepatic glucose production using D-[3-3H]glucose.
Main Results:
- Identified two NIDDM populations: one with normal insulin sensitivity and another with significant insulin resistance.
- Insulin-resistant NIDDM patients exhibited elevated basal plasma insulin levels and lower basal hepatic glucose production compared to sensitive individuals.
- Hepatic insulin action was preserved in both NIDDM groups, suggesting peripheral insulin resistance is a key factor.
Conclusions:
- NIDDM pathogenesis involves distinct patient profiles regarding insulin sensitivity.
- Elevated basal insulin levels in insulin-resistant NIDDM patients may suppress hepatic glucose production.
- Peripheral insulin resistance, rather than hepatic dysfunction, appears central to the studied NIDDM phenotypes.