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Metabolic abnormalities in children of non-insulin dependent diabetics
Insights
Young offspring of non-insulin dependent diabetics show early metabolic changes, including impaired glucose tolerance. These findings suggest a genetic predisposition to diabetes, detectable before clinical diagnosis.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Genetics
Background:
- Non-insulin dependent diabetes (NIDDM) is considered an inherited condition.
- Early identification of metabolic abnormalities in offspring of NIDDM patients can aid in understanding disease development.
Purpose of the Study:
- To investigate metabolic abnormalities in young, non-diabetic offspring of NIDDM patients.
- To determine if preclinical metabolic changes are present before the onset of clinical diabetes.
Main Methods:
- A study involving 32 offspring (aged 12-45) of NIDDM patients with a diabetic sibling and non-diabetic spouse.
- Oral glucose tolerance tests (OGTT) were performed.
- Offspring metabolic profiles were compared to controls.
Main Results:
- Offspring exhibited higher fasting glucose, HbA1c, insulin, C-peptide, and glucagon levels compared to controls.
- Greater glucose and C-peptide responses to OGTT were observed in offspring.
- Seven offspring showed impaired glucose tolerance; metabolic differences persisted across all 32 offspring.
Conclusions:
- Young offspring of NIDDM patients display significant preclinical metabolic alterations.
- Hyperinsulinaemia and hyperglucagonaemia are associated with these early metabolic changes.
- These findings support the inherited nature of NIDDM and highlight potential early biomarkers.
Abstract:
Non-insulin dependent diabetes appears to be an inherited condition. A study of young offspring of non-insulin dependent diabetics was conducted to determine whether metabolic abnormalities could be found at a young age before clinical diabetes developed. Thirteen patients with non-insulin dependent diabetes were selected who fulfilled the following criteria: they had a sibling who also had non-insulin dependent diabetes, their spouse was non-diabetic, and the offspring were aged between 12 and 45 years, not diabetic, and available for study. All 32 offspring had a 75 g oral glucose tolerance test, and results in 13 of them, one randomly selected from each family, were compared with 13 controls of similar age, sex, and weight. The offspring had significantly higher fasting concentrations of glucose, higher proportions of haemoglobin A1, and higher concentrations of insulin, C peptide, and glucagon. After glucose challenge the increases in both glucose and C peptide concentrations were significantly greater in the offspring. These differences were maintained in all 32 offspring when compared with 18 controls of similar age, sex, and weight; seven of the 32 offspring had impaired glucose tolerance. These results indicate that young offspring of selected non-insulin dependent diabetics can show extensive metabolic changes including impaired glucose tolerance. These changes are associated with hyperinsulinaemia and hyperglucagonaemia.